Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope

Kazemi, B. and Haghjoo, M. and Arya, A. and Sadr-Ameli, M.A. (2006) Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope. PACE - Pacing and Clinical Electrophysiology, 29 (8). pp. 846-851.

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Background: Unexplained syncope is a relatively frequent symptom, mostly caused by a neurocardiogenic reaction. The purpose of this study was to determine predictors of response to head-up tilt testing (HUTT) in patients with unexplained syncope or presyncope. Methods: HUTT was done in 640 consecutive patients with unexplained syncope or presyncope (393 men, mean age 45 ± 19 years) after initial workup including history, physical examination, and appropriate laboratory evaluation. Results: Three hundred and forty-four (54) patients had a positive result. The most common type of response was mixed type (46) followed by vasodepressor (39) and cardioinhibitory (15) types. Age, gender, presence of structural heart disease, baseline heart rhythm, and the presenting symptom before the test failed to predict a positive response to HUTT, but among patients with a positive response to the test, age (OR: 1.54, CI = 1.04-2.47, P = 0.016) and presyncope (OR: 2.16, CI = 1.2-3.85, P = 0.008) as the presenting symptom predicted a vasodepressor type of response. The age (OR: 1.58, CI = 1.29-3.94, P = 0.01) and presyncope (OR: 4.6, CI = 1.74-12.24, P = 0.001) were also predictors for test positivity in the active stage. Conclusions: There is an age-related gradient in hemodynamic response during neurocardiogenic syncope. The elderly patients more commonly had a vasodepressor and late response, in the active stage, but young subjects more commonly experienced an earlier and cardioinhibitory or mixed responses in the passive stage. ©2006, The Authors.

Item Type: Article
Additional Information: cited By 9
Uncontrolled Keywords: adolescent; adult; age; aged; anamnesis; article; cardiovascular response; depressor response; electrocardiography; female; gender; head tilting; heart disease; heart rhythm; hemodynamics; human; laboratory test; major clinical study; male; physical examination; prediction; presyncope; school child; statistical analysis; syncope, Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Child; Female; Humans; Iran; Male; Middle Aged; Outcome Assessment (Health Care); Prevalence; Prognosis; Reproducibility of Results; Retrospective Studies; Risk Assessment; Risk Factors; Sensitivity and Specificity; Sex Distribution; Syncope, Vasovagal; Tilt-Table Test
Subjects: WG Cardiovascular System
Depositing User: Librarian Farzaneh Dini
Date Deposited: 08 Apr 2020 04:11
Last Modified: 08 Apr 2020 04:11

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