223 The bradycardia-hypotension reaction during head-up tilt test in patients with syncope: prevalence and value of blood pressure and heart rate behavior during the early stage of the test

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 45-45
Author(s):  
G.A. Ruiz ◽  
R. Chirife ◽  
M.C. Tentori ◽  
D. Dasso ◽  
R. Gelpi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Early Stage ◽  
Tilt Test ◽  
Head Up Tilt ◽  
Rate Behavior ◽  
Head Up Tilt Test

Abnormal passive head-up tilt test in subjects with symptoms of anxiety power spectral analysis study of heart rate and blood pressure

1997 ◽  
Vol 60 (2) ◽  
pp. 121-131 ◽  
Author(s):  
Gianfranco Piccirillo ◽  
Santagada Elvira ◽  
Carmela Bucca ◽  
Emanuela Viola ◽  
Mauro Cacciafesta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Spectral Analysis ◽  
Power Spectral Analysis ◽  
Tilt Test ◽  
Analysis Study ◽  
Power Spectral ◽  
Head Up Tilt ◽  
Head Up Tilt Test

scholarly journals Mathematical modeling of the cardiovascular autonomic control in healthy subjects during a passive head-up tilt test

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yurii M. Ishbulatov ◽  
Anatoly S. Karavaev ◽  
Anton R. Kiselev ◽  
Margarita A. Simonyan ◽  
Mikhail D. Prokhorov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Healthy Subjects ◽  
Low Frequency ◽  
Tilt Test ◽  
Peripheral Vascular ◽  
Control Loops ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Abstract A mathematical model is proposed for the autonomic control of cardiovascular system, which takes into account two separated self-exciting sympathetic control loops of heart rate and peripheral vascular tone. The control loops are represented by self-exciting time-delay systems and their tone depends on activity of the aortic, carotid, and lower-body baroreceptors. The model is used to study the dynamics of the adaptive processes that manifest in a healthy cardiovascular system during the passive head-up tilt test. Computer simulation provides continuous observation of the dynamics of the indexes and variables that cannot be measured in the direct experiment, including the noradrenaline concentration in vessel wall and heart muscle, tone of the sympathetic and parasympathetic control, peripheral vascular resistance, and blood pressure. In the supine and upright positions, we estimated the spectral characteristics of the model variables, especially in the low-frequency band, and the original index of total percent of phase synchronization between the low-frequency oscillations in heart rate and blood pressure signals. The model demonstrates good quantitative agreement with the dynamics of the experimentally observed indexes of cardiovascular system that were averaged for 50 healthy subjects.

scholarly journals Predictive Value of Blood Pressure, Heart Rate, and Blood Pressure/Heart Rate Ratio in a Chinese Subpopulation with Vasovagal Syncope

2020 ◽  
Author(s):  
Dengfeng Geng
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Vasovagal Syncope ◽  
Cost Effective ◽  
Tilt Test ◽  
Clinical Settings ◽  
Mixed Response ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Mixed Pattern

Objective: The head-up tilt test (HUTT) is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope (VVS). The present study aims to verify the hypothesis that ambulatory blood pressure (BP) monitoring (ABPM) and the simplistic tilt test may be potential alternatives to the HUTT.Methods: The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS. BP), heart rate(HR), and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence, pattern, and stage of syncope during the HUTT.Results: Mixed response was the commonest pattern, and syncope occurred frequently with infusion of isoproterenol at a rate of 3 μg/min. During the simplistic tilt test, the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group, while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group. The higher the BP/HR ratio in the titled position, the higher the isoproterenol dosage needed to induce a positive response. During ABPM, BP/HR ratios were significantly higher in the cardioinhibitory group than in the vasodepressor group. The higher the ABPM-derived BP, the higher the dosage of isoproterenol needed to induce syncope. There were significant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group, while significant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group. The mixed pattern shared correlative features of the other two patterns.Conclusion: ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.

Personalized Simulated HUT as an At-home Prediction Model for Heart Rate Changes in Syncope Patients and At-home, Orthostatic Self-training Efficacy

2021 ◽  
Author(s):  
Dahlia Hassan ◽  
Dominik Wehler ◽  
Robert Krones ◽  
Helmut Ahammer ◽  
Herbert F. Jelinek
Keyword(s):  
Heart Rate ◽  
Early Stage ◽  
Clinical Findings ◽  
Patient Specific ◽  
Tilt Test ◽  
Home Based ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Home Training ◽  
At Home

Abstract Head-up tilt (HUT) testing supports the diagnosis of syncope by detecting abnormalities in heart rate and blood pressure changes. Home-based self-training can be of benefit to neurocardiogenic patients if during clinical HUT, heart rate decreases in the early stage of being in an upright position. However, HUT testing is not always possible in the hospital as it is inconvenient and sometimes even risky for patients with cardiac abnormalities as it may trigger a loss of consciousness and arrhythmia. To address this, the current paper introduces a personalized HUT simulation to determine the efficacy of at-home training. To develop the model, Holter ECG recordings were obtained from 28 syncope patients and the simulated output was compared to clinical findings. The model aims to predict heart rate changes associated with the simulated HUT that can indicate efficacy of an at-home program. Heart rate represents a variable of velocity in the model measured in liters per second against gravity. The results show that a decrease in heart rate in early simulated HUT as determined by the model shows a greater than 84% efficiency for syncope patients to benefit from at-home training and allows physicians to recommend home training during an online or telemedicine consultation. Keywords— head-up tilt test, syncope, blood flow, heart rate prediction Clinical Relevance— The cardiovascular model predicts the patient-specific efficacy of at home tilt-training for patients diagnosed with syncope.

scholarly journals Haemodynamic Characteristics And Factors Influencing The Head-Up Tilt Test In Patients With Orthostatic Hypotension

2021 ◽  
Author(s):  
Wang Jiayu ◽  
Wu Yueyang ◽  
Wang Yongjun ◽  
Zhao Xingquan ◽  
Wang Yilong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stroke Volume ◽  
Systolic Blood Pressure ◽  
Orthostatic Hypotension ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Tilt Test ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Abstract Background: Failure to activate autonomic neural and hormonal reflex mechanisms could result in orthostatic hypotension. Patients with orthostatic hypotension often experience symptoms of cerebral hypoperfusion, including syncope. The purpose of this study was to investigate the haemodynamic characteristics of patients with orthostatic hypotension and the factors affecting blood pressure regulation.Methods: This retrospective study enrolled 45 patients who were diagnosed with typical orthostatic hypotension by the head-up tilt test at Beijing Tiantan Hospital, Capital Medical University from June 2019 to December 2020. Changes in haemodynamic parameters in these patients were compared in the supine and tilted upright positions.Results: For all patients, haemodynamic parameters in the supine and tilted upright positions were compared, and systolic blood pressure, diastolic blood pressure, mean blood pressure, cardiac output and stroke volume were all significantly decreased per minute. Heart rate significantly increased per minute, but systemic vascular resistance did not significantly change. The absolute value, percentage and rate of increases in heart rate and the absolute value, percentage and rate of decreases in stroke volume from the supine to the titled upright position were significantly lower in patients 60 years and older than in patients under 60 years old. Linear regression analyses found that the changes in heart rate, stroke volume and systemic vascular resistance were related to changes in systolic blood pressure, while the changes in stroke volume and systemic vascular resistance had more important effects on systolic blood pressure.Conclusions: In patients with orthostatic hypotension, we observed no significant increase in systemic vascular resistance from the supine position to the tilted upright position. Nevertheless, an increase in systemic vascular resistance had a significant impact on the maintenance of systolic blood pressure. In addition, in orthostatic hypotension patients younger than 60 years of age, heart rate increased while stroke volume decreased significantly after tilting upright compared with orthostatic hypotension patients older than 60 years of age and older.

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