Tags

Type your tag names separated by a space and hit enter

Provocation of neurocardiogenic syncope during head-up tilt testing in children: comparison between isoproterenol and nitroglycerin.
Pediatrics. 2007 Feb; 119(2):e419-25.Ped

Abstract

OBJECTIVE

Although nitroglycerin- and isoproterenol-augmented tilt tests are of equal value in the diagnosis of neurocardiogenic syncope in adults, no data exist in children. We compared the sensitivity and specificity of the 2 tests in a pediatric population.

PATIENTS AND METHODS

We studied 85 patients (33 boys; mean age: 11.6 +/- 2.9 years). Of them, 56 had a diagnostic history of neurocardiogenic syncope, whereas 29 served as controls. After a negative passive phase, they were randomly assigned to either intravenous isoproterenol or sublingual nitroglycerin, and tilt was continued for 20 minutes.

RESULTS

Sensitivity was 0.78 for the isoproterenol test and 0.79 for the nitroglycerin test, but specificity was significantly higher for isoproterenol test compared with nitroglycerin test. In patients with a positive test, the duration of the recovery period was significantly longer after nitroglycerin (8.4 +/- 2.7 minutes) than after isoproterenol (5.1 +/- 1.6 minutes).

CONCLUSIONS

Nitroglycerin- and isoproterenol-augmented tilt tests are associated with equal sensitivity in the diagnosis of neurocardiogenic syncope in children and adolescents. However, nitroglycerin results in more false-positive tests and produces more prolonged vasovagal symptoms. Our data do not support the routine use of nitroglycerin in the evaluation of syncope in this age group.

Links

Publisher Full Text

Authors+Show Affiliations

Vlahos AP
Child Health Department, Pediatric Cardiology Division, University of Ioannina, 45110 Ioannina, Greece. anvlahos@uoi.gr
Tzoufi M
No affiliation info available
Katsouras CS
No affiliation info available
Barka T
No affiliation info available
Sionti I
No affiliation info available
Michalis LK
No affiliation info available
Siamopoulou A
No affiliation info available
Kolettis TM
No affiliation info available

MeSH

Administration, SublingualChildFemaleHumansInjections, IntravenousIsoproterenolMaleNitroglycerinSensitivity and SpecificitySyncope, VasovagalTilt-Table Test

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17224456

Citation

Vlahos, Antonios P., et al. "Provocation of Neurocardiogenic Syncope During Head-up Tilt Testing in Children: Comparison Between Isoproterenol and Nitroglycerin." Pediatrics, vol. 119, no. 2, 2007, pp. e419-25.
Vlahos AP, Tzoufi M, Katsouras CS, et al. Provocation of neurocardiogenic syncope during head-up tilt testing in children: comparison between isoproterenol and nitroglycerin. Pediatrics. 2007;119(2):e419-25.
Vlahos, A. P., Tzoufi, M., Katsouras, C. S., Barka, T., Sionti, I., Michalis, L. K., Siamopoulou, A., & Kolettis, T. M. (2007). Provocation of neurocardiogenic syncope during head-up tilt testing in children: comparison between isoproterenol and nitroglycerin. Pediatrics, 119(2), e419-25.
Vlahos AP, et al. Provocation of Neurocardiogenic Syncope During Head-up Tilt Testing in Children: Comparison Between Isoproterenol and Nitroglycerin. Pediatrics. 2007;119(2):e419-25. PubMed PMID: 17224456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Provocation of neurocardiogenic syncope during head-up tilt testing in children: comparison between isoproterenol and nitroglycerin. AU - Vlahos,Antonios P, AU - Tzoufi,Meropi, AU - Katsouras,Christos S, AU - Barka,Theodora, AU - Sionti,Irene, AU - Michalis,Lampros K, AU - Siamopoulou,Antigoni, AU - Kolettis,Theofilos M, Y1 - 2007/01/15/ PY - 2007/1/17/pubmed PY - 2007/3/21/medline PY - 2007/1/17/entrez SP - e419 EP - 25 JF - Pediatrics JO - Pediatrics VL - 119 IS - 2 N2 - OBJECTIVE: Although nitroglycerin- and isoproterenol-augmented tilt tests are of equal value in the diagnosis of neurocardiogenic syncope in adults, no data exist in children. We compared the sensitivity and specificity of the 2 tests in a pediatric population. PATIENTS AND METHODS: We studied 85 patients (33 boys; mean age: 11.6 +/- 2.9 years). Of them, 56 had a diagnostic history of neurocardiogenic syncope, whereas 29 served as controls. After a negative passive phase, they were randomly assigned to either intravenous isoproterenol or sublingual nitroglycerin, and tilt was continued for 20 minutes. RESULTS: Sensitivity was 0.78 for the isoproterenol test and 0.79 for the nitroglycerin test, but specificity was significantly higher for isoproterenol test compared with nitroglycerin test. In patients with a positive test, the duration of the recovery period was significantly longer after nitroglycerin (8.4 +/- 2.7 minutes) than after isoproterenol (5.1 +/- 1.6 minutes). CONCLUSIONS: Nitroglycerin- and isoproterenol-augmented tilt tests are associated with equal sensitivity in the diagnosis of neurocardiogenic syncope in children and adolescents. However, nitroglycerin results in more false-positive tests and produces more prolonged vasovagal symptoms. Our data do not support the routine use of nitroglycerin in the evaluation of syncope in this age group. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17224456/Provocation_of_neurocardiogenic_syncope_during_head_up_tilt_testing_in_children:_comparison_between_isoproterenol_and_nitroglycerin_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=17224456 DB - PRIME DP - Unbound Medicine ER -