scholarly journals Underlying hemodynamic differences are associated with responses to tilt testing

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Artur Fedorowski ◽  
Giulia Rivasi ◽  
Parisa Torabi ◽  
Madeleine Johansson ◽  
Martina Rafanelli ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Reflex Response ◽  
Tilt Test ◽  
Logistic Regression Models ◽  
Younger Age ◽  
Lower Blood ◽  
Unexplained Syncope ◽  
Multivariable Analyses ◽  
Relationship Of

AbstractAim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients considered likely to be of vasovagal reflex etiology, comparing patients who had tilt-induced reflex response with those who did not. Tilt-induced reflex response was defined as spontaneous symptom reproduction with characteristic hypotension and bradycardia. Relationship of demographics and baseline supine BP to tilt-test were assessed using logistic regression models. Individual records of 5236 patients (45% males; mean age: 60 ± 22 years; 32% prescribed antihypertensive therapy) were analyzed. Tilt-positive (n = 3129, 60%) vs tilt-negative patients had lower SBP (127.2 ± 17.9 vs 129.7 ± 18.0 mmHg, p < 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p < 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p < 0.001). In multivariable analyses, tilt-test positivity was independently associated with younger age (Odds ratio (OR) per 10 years:1.04; 95% confidence interval (CI), 1.01–1.07, p = 0.014), SBP ≤ 128 mmHg (OR:1.27; 95%CI, 1.11–1.44, p < 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17–1.50, p < 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38–1.81, p < 0.001). In conclusion, among patients with suspected reflex syncope, younger age, lower blood pressure and lower heart rate are associated with positive tilt-test result.

Tilt Test for Diagnosis of Unexplained Syncope in Pediatric Patients

PEDIATRICS ◽  
1991 ◽  
Vol 87 (3) ◽  
pp. 334-338 ◽  
Author(s):  
Otto G. Thilenius ◽  
Jose A. Quinones ◽  
Tarek S. Husayni ◽  
Janet Novak
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pediatric Patients ◽  
Cost Effective ◽  
Tilt Test ◽  
Common Cause ◽  
History Of ◽  
Unexplained Syncope ◽  
Β Blockers ◽  
Isoproterenol Infusion

Thirty-five teenage patients with a history of presyncope or syncope underwent passive head-up tilting to reproduce symptoms of syncope. If tilting alone did not induce syncope, isoproterenol infusion was given to increase heart rate to 150 to 160 beats per minute. In 80% of patients with a history of syncope, identical symptoms could be reproduced during tilting: an abrupt fall in blood pressure combined with profound nodal bradycardia, ranging from 32 to 86 beats per minute. These symptoms were quickly reversed by returning the patient to the supine position. For patients with frequent occurrences of syncope, especially when there was a history of trauma sustained during these episodes, a therapeutic regimen of either β blockers or 9α-fluorocortisol was begun. The mechanism of this common cause of syncope in childhood is neurocardiogenic in response to venous pooling and catecholamine-induced tachycardia. The tilt test is an excellent and cost-effective test for the workup of unexplained syncope in childhood.

scholarly journals Relation of body mass index (BMI) with cardiovascular response to head up tilt in healthy subjects

2020 ◽  
Vol 15 (1) ◽  
pp. 6-10
Author(s):  
Sadia Afrin Rimi ◽  
Shamima Sultana ◽  
Iffat Rezwana ◽  
Sultana Ferdousi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Healthy Subjects ◽  
Cardiovascular Response ◽  
Tilt Test ◽  
Tilt Table ◽  
Chi Square ◽  
Female Head ◽  
Head Up Tilt

Background: Tilt table test is used for the last few decades to detect cause in unexplained syncope. The response to tilting may vary physiologically with obesity. Objective: To assess the relationship of BMI to cardiovascular response to tilting. Methods: This experimental study was conducted from March 2019 to Feb 2020 on 90 healthy subjects with different BMI. Fifty one subjects of both gender with BMI 18.5-24.9 kg/m2 were included in the non-obese group and 39 subjects of both gender with BMI of 25-29.9 kg/m2 were included in overweight group and they were further subdivided into male and female. Head up tilting was done for 10 minutes at 600 by using a motorized tilt table. Systolic blood pressure (SBP), diastolic blood pressure (DBP) were recorded by an automatic sphygmomanometer. Heart rate (HR) and peripheral capillary oxygen saturation (SpO2) were measured by a pulse oximeter. For statistical analysis, Independent sample ‘t’ test, Pearson’s correlation test and Chi square tests were applied. Results: Significantly smaller rise of heart rate was observed in overweight males and greater fall of systolic blood pressure was observed in overweight females. Conclusion: This study concluded that over weight is associated with reduced orthostatic tolerance to head up tilt test in both genders. J Bangladesh Soc Physiol. 2020, June; 15(1): 6-10

Continuous assessment of hemodynamic control by complex demodulation of cardiovascular variability

1993 ◽  
Vol 264 (4) ◽  
pp. H1229-H1238 ◽  
Author(s):  
J. Hayano ◽  
J. A. Taylor ◽  
A. Yamada ◽  
S. Mukai ◽  
R. Hori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Dynamic Responses ◽  
Time Dependent ◽  
Frequency Resolution ◽  
Tilt Test ◽  
Continuous Assessment ◽  
Cardiovascular Variability ◽  
Complex Demodulation ◽  
Head Up Tilt

Usefulness of complex demodulation (CDM) in assessing the frequency components of cardiovascular variability was assessed and, subsequently, this technique was utilized to determine the time-dependent responses of the low-frequency (LF) and high-frequency (HF) amplitudes of heart rate and blood pressure variabilities during postural tilt. CDM provides the time-dependent changes in amplitude of a particular frequency component on a continuous basis. Analysis of simulated data showed that CDM has sufficient frequency resolution to separately measure LF and HF amplitudes with a time resolution < 15 s and that CDM is robust to alterations in the frequency of the components. Analysis of actual data during postural tilt test in 23 young healthy subjects demonstrated that the HF amplitude of heart rate, an index of cardiac parasympathetic tone, rapidly decayed with head-up tilt (P < 0.01) and increased quickly showing an overshoot with tilt back to the supine position (P < 0.01). The LF amplitude of blood pressure, an index of vasomotor sympathetic activity, showed marked rhythmic fluctuation at an interval of 48-100 s during head-up tilt (P < 0.01), synchronizing with similar fluctuation in the LF amplitude of heart rate (P < 0.01). These results suggest that CDM can be used to provide a continuous assessment of cardiovascular variability components and that the dynamic responses of autonomic circulatory control to upright posture result in a phasic modulation of LF amplitude.

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

PM337 Relationship of age and underweight with systolic and diastolic blood pressure, pulse pressure and heart rate among blacks schoolchildren in Central Africa Country

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e130
Author(s):  
Bertrand F. Ellenga Mbolla ◽  
Thierry R. Gombet ◽  
Annie R. Okoko ◽  
Christian M. Koula Landa ◽  
suzy-Gisèle Kimbally-Kaky ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diastolic Blood Pressure ◽  
Pulse Pressure ◽  
Pressure Pulse ◽  
Central Africa ◽  
Relationship Of

LABORATORY DEMONSTRATION OF BAROREFLEX CONTROL OF HEART RATE IN CONSCIOUS RATS

2002 ◽  
Vol 26 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Theresa L. O’Donaughy ◽  
Thomas C. Resta ◽  
Benjimen R. Walker
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Pressure ◽  
Peripheral Resistance ◽  
Baroreflex Control ◽  
Laboratory Exercise ◽  
Conscious Animal ◽  
Lecture Material ◽  
Arterial Blood ◽  
Lower Blood

We have developed a laboratory exercise that demonstrates arterial baroreflex control of heart rate (HR) in the conscious unrestrained rat, incorporating graduate level physiological topics as well as a hands-on exposure to conscious animal research. This demonstration utilizes rats chronically instrumented to measure cardiac output (CO), HR, and arterial blood pressure in response to agents that raise or lower blood pressure. The HR response to progressive increases or decreases in blood pressure is recorded, and a baroreflex curve is generated by plotting mean arterial blood pressure (MABP) vs. HR. Observation of altered CO allows for discussion of the relationship between MAP, CO, HR, stroke volume, and total peripheral resistance. Administration of arginine vasopressin demonstrates the ability of this hormone to alter the sensitivity of the baroreflex. Throughout the demonstration, students answer questions from a handout about general cardiovascular physiology, specific pathways of agonists, and the baroreflex system, encouraging group and individual critical analysis of the results. Interpretation of the data reemphasizes lecture material and allows students to observe the baroreflex response in a physiological setting.

Usefulness of tilt test–induced patterns of heart rate and blood pressure using a two-stage protocol with glyceryl trinitrate provocation in patients with syncope of unknown origin

1999 ◽  
Vol 84 (6) ◽  
pp. 665-670 ◽  
Author(s):  
Arvinder S Kurbaan ◽  
Ann-Christine Franzén ◽  
Timothy J Bowker ◽  
Timothy R Williams ◽  
Samer Kaddoura ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Glyceryl Trinitrate ◽  
Unknown Origin ◽  
Tilt Test ◽  
Two Stage
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