P1514 Nitrate stimulate head up tilt testing potentiates the predictive value of the tilt test on the risk of recurrence in patients with vasovagal syncope

Abstract Head-up tilt test (TT) has been used for >50 years to study heart rate/blood pressure adaptation to positional changes, to model responses to haemorrhage, to assess orthostatic hypotension, and to evaluate haemodynamic and neuroendocrine responses in congestive heart failure, autonomic dysfunction, and hypertension. During these studies, some subjects experienced syncope due to vasovagal reflex. As a result, tilt testing was incorporated into clinical assessment of syncope when the origin was unknown. Subsequently, clinical experience supports the diagnostic value of TT. This is highlighted in evidence-based professional practice guidelines, which provide advice for TT methodology and interpretation, while concurrently identifying its limitations. Thus, TT remains a valuable clinical asset, one that has added importantly to the appreciation of pathophysiology of syncope/collapse and, thereby, has improved care of syncopal patients.

Download Full-text

Enhanced plasma catecholamine and cAMP response during the head-up tilt test in patients with vasovagal syncope

Wiener klinische Wochenschrift ◽

10.1007/s00508-005-0331-1 ◽

2005 ◽

Vol 117 (9-10) ◽

pp. 353-358 ◽

Cited By ~ 3

Author(s):

Peter Mitro ◽

Emilia Rybárová ◽

Eva Žemberová ◽

Ivan Tkáč

Keyword(s):

Vasovagal Syncope ◽

Tilt Test ◽

Plasma Catecholamine ◽

Head Up Tilt ◽

Head Up Tilt Test

Download Full-text

Clinical Features, Prodrome Types and Vasovagal Syncope Types in Passive and Nitrate Potentiated Head Up Tilt Test

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.09.035 ◽

2013 ◽

Vol 62 (18) ◽

pp. C48-C49

Author(s):

Lale Dinç Asarcıklı ◽

Habibe Kafes ◽

Yesim Guray ◽

Umit Guray ◽

Esra Gucuk İpek ◽

...

Keyword(s):

Clinical Features ◽

Vasovagal Syncope ◽

Tilt Test ◽

Head Up Tilt ◽

Head Up Tilt Test

Download Full-text

Vasovagal Syncope: Diagnostic Role of Head-Up Tilt Test in Patients with Positive Ocular Compression Test

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.1990.tb04017.x ◽

1990 ◽

Vol 13 (11) ◽

pp. 1416-1423 ◽

Cited By ~ 17

Author(s):

FREDRICK J. JAEGER ◽

LORI SCHNEIDER ◽

JAMES D. MALONEY ◽

ROBERT P. CRUSE ◽

FETNAT M. FOUAD-TARAZI

Keyword(s):

Compression Test ◽

Vasovagal Syncope ◽

Tilt Test ◽

Diagnostic Role ◽

Head Up Tilt ◽

Head Up Tilt Test

Download Full-text

The Repolarization Period during the Head-Up Tilt Test in Children with Vasovagal Syncope

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061908 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1908 ◽

Cited By ~ 1

Author(s):

Ewelina Kolarczyk ◽

Grażyna Markiewicz-Łoskot ◽

Lesław Szydłowski

Keyword(s):

Vasovagal Syncope ◽

Clinical Importance ◽

Clinical Work ◽

Ventricular Repolarization ◽

Tilt Test ◽

Wave Refraction ◽

T Wave ◽

Prolonged Duration ◽

Head Up Tilt ◽

Head Up Tilt Test

Background: Electrocardiography (ECG) and the head-up tilt test (HUTT) are vital in clinical work-up in children with vasovagal syncope (VVS). Ventricular repolarization parameters (QT) measured during the HUTT can be indicative of electrical instability; however, these parameters are not frequently assessed. This study aimed to investigate if ventricular repolarization parameters measured during the HUTT could be indicative of future ventricular arrhythmias in children with syncope. Methods: The shape and amplitude of the T-wave and parameters of the repolarization period (QT, QTpeak, Tpeak-Tend) were evaluated in a resting ECG performed on the first day of hospitalization and in ECGs performed during three phases of the HUTT. Results: In the after-tilt phase of the HUTT, 19/30 children displayed a change in T-wave morphology. QTc was significantly longer in VVS I compared to that in VVS II patients, but not in the controls (p = 0.092). Conclusions: We need further follow-up studies to establish the clinical importance of abnormal dynamics of the repolarization period in children with VVS and negative HUTT. Therefore, children with abnormal T-wave refraction and prolonged duration of the TpTe should remain under the care of a cardiological outpatient.

Download Full-text