SHORT HEAD-UP TILT TEST

Objective: The aim of the present study was to evaluate the time to syncope in Nitroglycerine potentiated short Head-up tilt test.Study Design, Settings & Duration: This was a descriptive cross sectional study conducted in Armed Forces Institute of cardiology from May2006 to May, 2007. Patients and methods: A total number of 90 patients with orthostatic intolerance both male and female were studied.Head-up tilt test protocol consisted of a Stabilization phase which lasted for five minutes Passive tilt phase: Patients were tilted at 70̊ fororthostatic stress for 15 minutes. In case of no symptoms the test continued with the drug provocation phase which lasted for 15 minutes. Thepatients were administered 400μg of nitroglycerine sublingually in aerosol preparation. Development of symptoms were noted at 5, 10 and 15minutes. Results: A total number of 90 patients were examined during the study period. The tilt table test was classified as positive in 58.9 % ofpatients and was negative in 41.1%. The test was positive in five patients without the drug provocation (9.4%). The responses were classifiedas positive vasodepressor in 35.8%, 15.09% as mixed and cardioinhibitory 15.09% in patients of neurally mediated syncope. The total time todisplay of symptoms to positivity in HUTT was 17.89± 6.99. The mean time to syncope after the administration of nitroglycerine was 5.61± 4.17minutes. Conclusions: Our study concludes that the drug administered phase can be reduced to 12±3 minutes.

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Orthostatic intolerance in adults with long COVID was not associated with postural orthostatic tachycardia syndrome

10.1101/2021.12.19.21268060 ◽

2021 ◽

Author(s):

Ann Monaghan ◽

Glenn Jennings ◽

Feng Xue ◽

Lisa Byrne ◽

Eoin Duggan ◽

...

Keyword(s):

Daily Living ◽

Orthostatic Intolerance ◽

Cross Sectional Study ◽

Tilt Test ◽

Postural Orthostatic Tachycardia Syndrome ◽

Sectional Study ◽

Cross Sectional ◽

Minute Post ◽

Head Up Tilt ◽

Head Up Tilt Test

In this observational cross-sectional study, we investigated predictors of orthostatic intolerance (OI) in adults with long COVID. Participants underwent a 3-minute active stand (AS) with Finapres NOVA, followed by a 10-minute unmedicated 70-degree head-up tilt test. 85 participants were included (mean age 46 years, range 25-78; 74% women), of which 56 (66%) reported OI during AS (OIAS). OIAS seemed associated with female sex, more fatigue and depressive symptoms, and greater inability to perform activities of daily living (ADL), as well as a higher heart rate (HR) at the lowest systolic blood pressure (SBP) point before the 1st minute post-stand (mean HRnadir: 88 vs 75 bpm, P=0.004). In a regression model also including age, sex, fatigue, depression, ADL inability, and peak HR after the nadir SBP, HRnadir was the only OIAS predictor (OR=1.09, 95% CI: 1.01-1.18, P=0.027). 22 participants had initial (iOH) and 5 classical (cOH) orthostatic hypotension, but neither correlated with OIAS. 71 participants proceeded to tilt, of which 28 had OI during tilt (OItilt). Of the 53 who had a 10-minute tilt, 7 (13%) fulfilled hemodynamic postural orthostatic tachycardia syndrome (POTS) criteria, but 6 did not report OItilt. OIAS was associated with a higher initial HR on AS, which after 1 minute equalized with the non-OIAS group. Despite these initial orthostatic HR differences, POTS was infrequent and largely asymptomatic. ClinicalTrials.gov Identifier: NCT05027724 (retrospectively registered on August 30, 2021).

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Autonomic cardiovascular regulation in Parkinson's disease by head-up tilt test - A cross-sectional study

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2018.8.0413615052018 ◽

2018 ◽

Vol 8 (9) ◽

pp. 1287

Author(s):

Raksha Jaipurkar ◽

Latika Mohan ◽

Rajesh Tomar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cardiovascular Regulation ◽

Cross Sectional Study ◽

Tilt Test ◽

Sectional Study ◽

Cross Sectional ◽

Head Up Tilt ◽

Head Up Tilt Test

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Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response

Revista de investigaci�n Cl�nica ◽

10.24875/ric.21000199 ◽

2021 ◽

Author(s):

J. Antonio González-Hermosillo ◽

Alan Rubio-Vega ◽

Karla A. F. González-Olvera ◽

Manuel Sierra-Beltrán ◽

Andrei Kostine ◽

...

Keyword(s):

Orthostatic Intolerance ◽

Cerebral Hypoperfusion ◽

Tilt Test ◽

Head Up Tilt ◽

Head Up Tilt Test ◽

Vasovagal Response

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Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome

The American Journal of Cardiology ◽

10.1016/0002-9149(91)90491-3 ◽

1991 ◽

Vol 68 (10) ◽

pp. 1032-1036 ◽

Cited By ~ 76

Author(s):

Michele Brignole ◽

Carlo Menozzi ◽

Lorella Gianfranchi ◽

Daniele Oddone ◽

Gino Lolli ◽

...

Keyword(s):

Carotid Sinus ◽

Sick Sinus Syndrome ◽

Tilt Test ◽

Carotid Sinus Massage ◽

Neurally Mediated Syncope ◽

Head Up Tilt ◽

Head Up Tilt Test

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Assessment of therapeutic biomarkers in the treatment of children with postural tachycardia syndrome and vasovagal syncope

Cardiology in the Young ◽

10.1017/s1047951114000316 ◽

2014 ◽

Vol 24 (5) ◽

pp. 792-796 ◽

Cited By ~ 9

Author(s):

Jing Lin ◽

Hongfang Jin ◽

Junbao Du

Keyword(s):

Orthostatic Intolerance ◽

Vasovagal Syncope ◽

Urinary Sodium Excretion ◽

Tilt Test ◽

Postural Tachycardia Syndrome ◽

Postural Tachycardia ◽

Ovid Medline ◽

Head Up Tilt ◽

Head Up Tilt Test ◽

Flow Mediated Vasodilation

AbstractBackground: Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. The supplementation with water, or salt, or midodrine, or β-blocker was applied to children with postural tachycardia syndrome or vasovagal syncope. However, the efficacy of such medication varied and was not satisfied. This review aimed to summarise the current biomarkers in the treatment of the diseases. Data sources: Studies were collected from online electronic databases, including OVID Medline, PubMed, ISI Web of Science, and associated references. The main areas assessed in the included studies were clinical improvement, the cure rate, and the individualised treatment for postural tachycardia syndrome and vasovagal syncope in children. Results: Haemodynamic change during head-up tilt test, and detection of 24-hour urinary sodium excretion, flow-mediated vasodilation, erythrocytic H2S, and plasma pro-adrenomedullin as biological markers were the new ways that were inexpensive, non-invasive, and easy to test for finding those who would be suitable for a specific drug and treatment. Conclusion: With the help of biomarkers, the therapeutic efficacy was greatly increased for children with postural tachycardia syndrome and vasovagal syncope.

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Clinical Significance of the Head-Up Tilt Test in Improving Prognosis in Patients with Possible Neurally Mediated Syncope

Biology ◽

10.3390/biology10090919 ◽

2021 ◽

Vol 10 (9) ◽

pp. 919

Author(s):

Kengo Ayabe ◽

Tomoyoshi Komiyama ◽

Misaki Hasegawa ◽

Tetsuri Sakai ◽

Masahiro Morise ◽

...

Keyword(s):

Clinical Significance ◽

Clinical Information ◽

University Hospital ◽

Tilt Test ◽

Cardiac Events ◽

Clinical Events ◽

Neurally Mediated Syncope ◽

Significant Difference ◽

Head Up Tilt ◽

Head Up Tilt Test

Syncope is commonly encountered in daily clinical practice. Depending on its etiology (benign or life-threatening conditions or environmental triggers), syncope can be neurally mediated (reflex), cardiac, or orthostatic. Furthermore, neurologic disease can cause symptoms that mimic syncope. However, there is limited research on neurally mediated syncope (NMS), which is considered a benign disorder, and close follow-ups are rarely performed. NMS can cause serious clinical events, including severe trauma and car accidents. The head-up tilt test (HUTT) is the gold standard for diagnosing NMS; however, its clinical significance remains unknown, and its relevance to NMS prognosis requires further research. This retrospective study aimed to assess the clinical significance of the HUTT for NMS. We reviewed the charts of 101 patients who underwent HUTT at Tokai University Hospital in Japan between January 2016 and March 2019. During the HUTT, 72 patients (69.2%) experienced syncope. Patients were followed up for 886.1 ± 457.7 days (interquartile range: 518–1293 days). The syncope recurrence rate was 16.9%; however, no significant difference was observed between the two groups (HUTT positive vs. negative) (13.8% vs. 18.1%, p = 0.772). Four of 29 (13.9%) and two of 72 (2.8%) patients in the negative and positive HUTT groups, respectively, experienced cardiac events (p = 0.019). Negative HUTT results may assist in anticipating unexpected clinical events within a few years. A negative HUTT result may allow us to reconsider the NMS diagnosis based on clinical information. Close outpatient follow-up of patients with negative HUTT results is warranted.

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