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Tilt testing potentiated with sublingual nitroglycerin in children with unexplained syncope.
Eur Heart J. 2007 Nov; 28(21):2605-9.EH

Abstract

AIMS

The aim of this prospective study was to assess the diagnostic value of a sublingual nitroglycerin (NTG) potentiated head-up tilt (HUT) testing protocol in children with unexplained syncope.

METHODS AND RESULTS

One hundred and sixty-four consecutive paediatric patients with syncope of unknown origin and no evidence of organic heart disease (115 female, mean age 13 +/- 3 years) and 29 control children underwent a sublingual NTG-potentiated tilt testing protocol. Paediatric patients and controls were tilted at 60 degrees for 20 min and, if no symptom occurred, for other 15 min after sublingual 400 mug spray NTG administration. During the drug-free phase of the test, 13 patients (8%) and no controls had a positive response. After drug administration, a positive response occurred in another 88 patients (55%) and in four controls (14%), whereas an exaggerated response was observed in nine patients (5%) and in four controls (14%). Thus, the positive rate and specificity of sublingual NTG HUT test in children were 63 and 86%, respectively. No relevant adverse events were observed during the test.

CONCLUSION

Tilt testing potentiated with sublingual NTG has proved to be effective and safe in unmasking the neurally mediated origin of unexplained syncope in children. The NTG challenge greatly increased the positive rate of passive tilt, with a small decrease in specificity.

Authors+Show Affiliations

Cardiology Department, Ospedale Valduce, Via Dane, 11, 22100 Como, Italy. gfoglia@valduce.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17911368

Citation

Foglia-Manzillo, Giovanni, et al. "Tilt Testing Potentiated With Sublingual Nitroglycerin in Children With Unexplained Syncope." European Heart Journal, vol. 28, no. 21, 2007, pp. 2605-9.
Foglia-Manzillo G, Giada F, Fteita N, et al. Tilt testing potentiated with sublingual nitroglycerin in children with unexplained syncope. Eur Heart J. 2007;28(21):2605-9.
Foglia-Manzillo, G., Giada, F., Fteita, N., Nessi, I., Santarone, M., & Raviele, A. (2007). Tilt testing potentiated with sublingual nitroglycerin in children with unexplained syncope. European Heart Journal, 28(21), 2605-9.
Foglia-Manzillo G, et al. Tilt Testing Potentiated With Sublingual Nitroglycerin in Children With Unexplained Syncope. Eur Heart J. 2007;28(21):2605-9. PubMed PMID: 17911368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tilt testing potentiated with sublingual nitroglycerin in children with unexplained syncope. AU - Foglia-Manzillo,Giovanni, AU - Giada,Franco, AU - Fteita,Nadia, AU - Nessi,Italo, AU - Santarone,Mauro, AU - Raviele,Antonio, Y1 - 2007/10/02/ PY - 2007/10/4/pubmed PY - 2008/6/20/medline PY - 2007/10/4/entrez SP - 2605 EP - 9 JF - European heart journal JO - Eur Heart J VL - 28 IS - 21 N2 - AIMS: The aim of this prospective study was to assess the diagnostic value of a sublingual nitroglycerin (NTG) potentiated head-up tilt (HUT) testing protocol in children with unexplained syncope. METHODS AND RESULTS: One hundred and sixty-four consecutive paediatric patients with syncope of unknown origin and no evidence of organic heart disease (115 female, mean age 13 +/- 3 years) and 29 control children underwent a sublingual NTG-potentiated tilt testing protocol. Paediatric patients and controls were tilted at 60 degrees for 20 min and, if no symptom occurred, for other 15 min after sublingual 400 mug spray NTG administration. During the drug-free phase of the test, 13 patients (8%) and no controls had a positive response. After drug administration, a positive response occurred in another 88 patients (55%) and in four controls (14%), whereas an exaggerated response was observed in nine patients (5%) and in four controls (14%). Thus, the positive rate and specificity of sublingual NTG HUT test in children were 63 and 86%, respectively. No relevant adverse events were observed during the test. CONCLUSION: Tilt testing potentiated with sublingual NTG has proved to be effective and safe in unmasking the neurally mediated origin of unexplained syncope in children. The NTG challenge greatly increased the positive rate of passive tilt, with a small decrease in specificity. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/17911368/Tilt_testing_potentiated_with_sublingual_nitroglycerin_in_children_with_unexplained_syncope_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehm430 DB - PRIME DP - Unbound Medicine ER -