Repolarization disparity as a predictor of response to Head Up Tilt‐table Test in pediatric syncope

(1) Background: The features characterizing vasovagal syncope (VVS) are an important factor in the correct evaluation of diagnostic risk stratification in children and adolescents. The aim of the study was to determine the value of identifying the clinical characteristics in children with VVS. (2) Methods: We made a retrospective analysis of the medical records of 109 children with diagnosed VVS. We investigated the specific characteristics of syncope in children with VVS including the positive VVS (+) and negative VVS (−) result of the Head-Up Tilt Table Test (HUTT). (3) Results: We did not observe significant differences in the prodromal symptoms of VVS with HUTT response. In addition to typical prodromal symptoms, no difference in statistically reported palpitations (35/109 or 32.1%) and chest discomfort (27/109 or 27.7%) were recorded. Fear–pain–stress emotions as circumstances of syncope were more often reported by children with a negative HUTT (p = 0.02). Cramps–contractures (p = 0.016) and speech disorders (p = 0.038) were significantly higher in the group with negative HUTT. (4) Conclusions: There is a close relationship in the diagnostic profile between the negative and positive results of head-up tilt table test in children with vasovagal syncope.

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Mitochondrial insufficiency is associated with autonomic nervous system dysfunction as confirmed by physiologic Head up Tilt table test (HUTT)

Mitochondrion ◽

10.1016/j.mito.2013.07.055 ◽

2013 ◽

Vol 13 (6) ◽

pp. 918-919

Author(s):

Mohammed Numan ◽

Ian Butler ◽

Rebecca Martinez ◽

Melissa Knight ◽

Nada Memon ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Tilt Table Test ◽

Tilt Table ◽

Autonomic Nervous System Dysfunction ◽

Autonomic Nervous ◽

Head Up Tilt

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Relationship between sarcopenia and orthostatic hypotension

Age and Ageing ◽

10.1093/ageing/afaa077 ◽

2020 ◽

Vol 49 (6) ◽

pp. 959-965 ◽

Cited By ~ 1

Author(s):

Pinar Soysal ◽

Suleyman Emre Kocyigit ◽

Ozge Dokuzlar ◽

Esra Ates Bulut ◽

Lee Smith ◽

...

Keyword(s):

Orthostatic Hypotension ◽

Healthcare Practitioner ◽

Tilt Table Test ◽

Older Patient ◽

Tilt Table ◽

European Consensus ◽

Close Relationship ◽

Head Up Tilt ◽

The Mean ◽

The Relationship

Abstract Background The relationship between sarcopenia and orthostatic hypotension (OH) is unclear. Objectives The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH. Design A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis. Results The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98–10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31–14.15; P = 0.016 for OH1; OR 4.09, CI 1.01–16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87–8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05). Conclusions There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.

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Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186441 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6441

Author(s):

Grażyna Markiewicz-Łoskot ◽

Ewelina Kolarczyk ◽

Bogusław Mazurek ◽

Marianna Łoskot ◽

Lesław Szydłowski

Keyword(s):

Vasovagal Syncope ◽

The Other ◽

Control Group ◽

Tilt Table Test ◽

Tilt Table ◽

T Wave ◽

Good Discriminator ◽

Wave Morphology ◽

Head Up Tilt ◽

T Waves

The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer (p < 0.001) compared to the other test phases and longer (p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter (p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

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