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Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope.
Pacing Clin Electrophysiol. 2006 Aug; 29(8):846-51.PC

Abstract

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.

Authors+Show Affiliations

Kazemi B
Department of Cardiology, Madani Cardiovascular Medical and Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. bkazemia1966@gmail.com
Haghjoo M
No affiliation info available
Arya A
No affiliation info available
Sadr-Ameli MA
No affiliation info available

MeSH

AdolescentAdultAge DistributionAgedAged, 80 and overChildFemaleHumansIranMaleMiddle AgedOutcome Assessment, Health CarePrevalencePrognosisReproducibility of ResultsRetrospective StudiesRisk AssessmentRisk FactorsSensitivity and SpecificitySex DistributionSyncope, VasovagalTilt-Table Test

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16923000

Citation

Kazemi, Babak, et al. "Predictors of Response to the Head-up Tilt Test in Patients With Unexplained Syncope or Presyncope." Pacing and Clinical Electrophysiology : PACE, vol. 29, no. 8, 2006, pp. 846-51.
Kazemi B, Haghjoo M, Arya A, et al. Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope. Pacing Clin Electrophysiol. 2006;29(8):846-51.
Kazemi, B., Haghjoo, M., Arya, A., & Sadr-Ameli, M. A. (2006). Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope. Pacing and Clinical Electrophysiology : PACE, 29(8), 846-51.
Kazemi B, et al. Predictors of Response to the Head-up Tilt Test in Patients With Unexplained Syncope or Presyncope. Pacing Clin Electrophysiol. 2006;29(8):846-51. PubMed PMID: 16923000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of response to the head-up tilt test in patients with unexplained syncope or presyncope. AU - Kazemi,Babak, AU - Haghjoo,Majid, AU - Arya,Arash, AU - Sadr-Ameli,Mohammad Ali, PY - 2006/8/23/pubmed PY - 2006/12/21/medline PY - 2006/8/23/entrez SP - 846 EP - 51 JF - Pacing and clinical electrophysiology : PACE JO - Pacing Clin Electrophysiol VL - 29 IS - 8 N2 - 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. SN - 0147-8389 UR - https://www.unboundmedicine.com/medline/citation/16923000/Predictors_of_response_to_the_head_up_tilt_test_in_patients_with_unexplained_syncope_or_presyncope_ DB - PRIME DP - Unbound Medicine ER -