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The effects of gender and test protocol on the results of head-up tilt test in patients with vasovagal syncope.
Kardiol Pol. 2009 Aug; 67(8A):1029-34.KP

Abstract

BACKGROUND

Head-up tilt testing (HUTT) is a well-established method for the diagnosis of reflex syncope. Some controversies exist whether gender and HUTT protocol influence HUTT results.

AIM

To analyse the results of HUTT in patients with syncope in relation to their gender and used protocol of HUTT.

METHODS

We retrospectively analysed data of 537 consecutive patients (313 women and 224 men), aged 13-79 years with history of neurally-mediated syncope referred to HUTT. The cardiogenic and neurological aetiology of syncope was excluded in all patients based on previous examination. In 375 patients standard HUTT (STD HUTT), according to the Westminster protocol, was used. In 257 patients in whom STD HUTT was negative, HUTT was continued with pharmacological provocation using isoproterenol intravenous infusion--114 patients (ISO HUTT) or sublingual nitroglycerin--143 patients (NTG HUTT). In the remaining 162 patients HUTT was performed according to the Italian protocol (ITL HUTT). The HUTT results were classified according to the VASIS scale.

RESULTS

Female gender dominated, however, syncope was induced in a similar proportion of women and men (77.3 vs. 70.5%, NS). There were also no significant differences in the type of vasovagal response (VVR) to HUTT between women and men. Mixed type of VVR was the most frequent after isoproterenol provocation (ISO HUTT), whereas cardioinhibitory type of VVR was the most frequent after nitroglycerin provocation (NTG HUTT).

CONCLUSIONS

There is no significant relationship between gender and the result of HUTT. The type of VVR is related to HUTT protocol--cardioinhibitory response is more frequent following nitroglycerin administration in comparison to standard protocol and HUTT with isoproterenol provocation.

Authors+Show Affiliations

Pietrucha A
Coronary Disease Department, Institute of Cardiology, Jagiellonian University Collegium Medicum, The John Paul II Hospital, Krakow, Poland. apietrucha@wp.pl
Wojewódka-Zak E
No affiliation info available
Wnuk M
No affiliation info available
Wegrzynowska M
No affiliation info available
Bzukała I
No affiliation info available
Nessler J
No affiliation info available
Mroczek-Czernecka D
No affiliation info available
Piwowarska W
No affiliation info available

MeSH

AdolescentAdultAgedFemaleHead-Down TiltHumansIsoproterenolMaleMiddle AgedNitroglycerinPeripheral Nervous SystemPolandRetrospective StudiesRisk FactorsSeverity of Illness IndexSex FactorsSympathetic Nervous SystemSyncope, VasovagalVasodilationVasodilator AgentsYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19784908

Citation

Pietrucha, Artur, et al. "The Effects of Gender and Test Protocol On the Results of Head-up Tilt Test in Patients With Vasovagal Syncope." Kardiologia Polska, vol. 67, no. 8A, 2009, pp. 1029-34.
Pietrucha A, Wojewódka-Zak E, Wnuk M, et al. The effects of gender and test protocol on the results of head-up tilt test in patients with vasovagal syncope. Kardiol Pol. 2009;67(8A):1029-34.
Pietrucha, A., Wojewódka-Zak, E., Wnuk, M., Wegrzynowska, M., Bzukała, I., Nessler, J., Mroczek-Czernecka, D., & Piwowarska, W. (2009). The effects of gender and test protocol on the results of head-up tilt test in patients with vasovagal syncope. Kardiologia Polska, 67(8A), 1029-34.
Pietrucha A, et al. The Effects of Gender and Test Protocol On the Results of Head-up Tilt Test in Patients With Vasovagal Syncope. Kardiol Pol. 2009;67(8A):1029-34. PubMed PMID: 19784908.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of gender and test protocol on the results of head-up tilt test in patients with vasovagal syncope. AU - Pietrucha,Artur, AU - Wojewódka-Zak,Ewa, AU - Wnuk,Mateusz, AU - Wegrzynowska,Marta, AU - Bzukała,Irena, AU - Nessler,Jadwiga, AU - Mroczek-Czernecka,Danuta, AU - Piwowarska,Wiesława, PY - 2009/9/29/entrez PY - 2009/9/29/pubmed PY - 2010/7/29/medline SP - 1029 EP - 34 JF - Kardiologia polska JO - Kardiol Pol VL - 67 IS - 8A N2 - BACKGROUND: Head-up tilt testing (HUTT) is a well-established method for the diagnosis of reflex syncope. Some controversies exist whether gender and HUTT protocol influence HUTT results. AIM: To analyse the results of HUTT in patients with syncope in relation to their gender and used protocol of HUTT. METHODS: We retrospectively analysed data of 537 consecutive patients (313 women and 224 men), aged 13-79 years with history of neurally-mediated syncope referred to HUTT. The cardiogenic and neurological aetiology of syncope was excluded in all patients based on previous examination. In 375 patients standard HUTT (STD HUTT), according to the Westminster protocol, was used. In 257 patients in whom STD HUTT was negative, HUTT was continued with pharmacological provocation using isoproterenol intravenous infusion--114 patients (ISO HUTT) or sublingual nitroglycerin--143 patients (NTG HUTT). In the remaining 162 patients HUTT was performed according to the Italian protocol (ITL HUTT). The HUTT results were classified according to the VASIS scale. RESULTS: Female gender dominated, however, syncope was induced in a similar proportion of women and men (77.3 vs. 70.5%, NS). There were also no significant differences in the type of vasovagal response (VVR) to HUTT between women and men. Mixed type of VVR was the most frequent after isoproterenol provocation (ISO HUTT), whereas cardioinhibitory type of VVR was the most frequent after nitroglycerin provocation (NTG HUTT). CONCLUSIONS: There is no significant relationship between gender and the result of HUTT. The type of VVR is related to HUTT protocol--cardioinhibitory response is more frequent following nitroglycerin administration in comparison to standard protocol and HUTT with isoproterenol provocation. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/19784908/The_effects_of_gender_and_test_protocol_on_the_results_of_head_up_tilt_test_in_patients_with_vasovagal_syncope_ L2 - https://antibodies.cancer.gov/detail/CPTC-KRAS4B-1 DB - PRIME DP - Unbound Medicine ER -