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Introduction: An imbalance between the sympathetic and parasympathetic nervous systems has been indicated in obesity. The aim of the present study was to evaluate the results of tilt table testing (TT) in obese patients., Methods: 59 patients with simple obesity (F/M: 50/9; BMI: 36.9+/-3.9 kg/m(2)), and 19 healthy subjects of the control group (F/M: 16/3; BMI: 24.7+/-4.3 kg/m(2)) were examined. Additionally, TT was carried out in 11 patients from the obese group after a 3-month weight reduction treatment. We evaluated HR (heart rate), SBP (systolic blood pressure), DBP (diastolic blood pressure): values at rest, post-inclination values (HRt-1, SBPt-1, DBPt-1), differences between the maximum and minimum values as obtained on TT (HRt-range, SBPt-range, DBPt-range), and % differences of HR (%HRt-increase, %HRt-decrease, %HRt-range)., Results: A positive TT response was observed in 10 obese patients, and in none of the controls. Higher differences of HR values were observed in the obese (P<0.05) in comparison to control group. Patients with a positive TT response presented a significant increase in HRt-1, HRt-range, and %HRt-range when compared to negative TT and controls (P<0.02). A 3-month weight reduction treatment resulted in a decrease in HR at rest, and decrease in SBP and DBP-both rest values and values after table-inclination., Conclusions: A positive TT response is observed more often in patients with simple obesity. HR reaction to tilting varies between the patients and controls. A 3-month weight reduction treatment influences the cardiovascular response to tilting. Our results seem to support the hypothesis of autonomic imbalance in obesity.

Background: Adhesion molecules have been suggested as mediators of atherosclerotic inflammatory process. They may contribute to the pathogenesis of stable and unstable angina., Methods: The study group consisted of 59 patients with coronary artery disease: 27 patients with stable exertional angina (group A), 32 patients with unstable angina (group B). 20 healthy persons acted as controls (group C). Serum levels of soluble Intercellular Adhesion Molecule 1 (sICAM-1), Vascular Cell Adhesion Molecule 1 (sVCAM-1), sE-selectin, sP-selectin were measured both before and after the treadmill ECG stress test in groups A and C. In group B the measurements were carried out at 6, 24, and 48 hours following an episode of chest pain., Results: There were no differences between the baseline serum levels of adhesion molecules as determined in groups A and C. In patients with stable angina, the post-exercise concentrations of sE-selectin were significantly higher (68.8+/-29 ng/ml) in comparison to both baseline- (38.7+/-15 ng/ml), and group C-values (pre-exercise: 35.1+/-16; post-exercise: 49.9+/-15 ng/ml). In unstable patients, serum sP-selectin (190.1+/-99 ng/ml) and sVCAM-1 levels (1359+/-299 ng/ml) were higher when compared to those found in groups A (142.3+/-24; 962+/-352 ng/ml, respectively) and C (136.4+/-33; 851+/-168 ng/ml, respectively)., Conclusions: Serum levels of soluble adhesion molecules in patients with stable angina are comparable to those of healthy persons. Stress test-induced increase of sE-selectin concentration may reflect endothelial response to exercise. Unstable angina is characterized by significant elevation of sP-selectin and sVCAM-1 serum levels which seems to be related to enhanced platelets and leukocytes activation.