Circulatory physiology remains ill-determined in children with a variety of problems with associated neurovascular dysfunction. Research focus is on vascular and autonomic dysfunction in such patients including altered peripheral arterial and venous properties and changes in blood volume and its redistribution. Molecular mechanisms including cytokine and nitric oxide assessment are explored. Treatment protocols are tested. Methods include plethysmographic measurements of peripheral blood flow, capacitance and peripheral permeability measurements, baroreflex assessment, standard circulatory autonomic function tests, and test of heart rate and blood pressure variability.
Orthostatic stress is used provocatively.
Other research interests include computational circulatory physiology investigating vascular and cardiac properties in animal model systems as well as during diagnostic procedures such as cardiac catheterization and cardiac monitoring including electrocardiography. Correlative work studying the relation of cardiovascular properties to nitric oxide physiology is in progress. Venous Dysfunction in chronic fatigue syndrome Journal Review Circulatory Research, Pediatric Research, AM J Physiol Journal of Pediatrics, Pace, Am Heart J, JACC goto top Selected Bibliography Stewart JM, Erb M, Sorbera C. Heart rate variability and the outcome of head-up tilt in syncopal children. Julian M. Stewart, Michael H Gewitz, Amy Weldon, Nina Arlievsky, Karl Li, Jose Munoz. The Nature of Neurally Mediated Hypotension in Adolescents with the Chronic Fatigue Syndrome.