scholarly journals Clinical Factors Affecting a Response of Head-Up Tilt Test in Suspected Neurally Mediated Syncope

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PE4_064
Author(s):  
Joon Hyouk Choi ◽  
Dae Kyung Cho ◽  
Seung-Jung Park ◽  
Hye Ran Yim ◽  
Young Keun On ◽  
...  
1991 ◽  
Vol 68 (10) ◽  
pp. 1032-1036 ◽  
Author(s):  
Michele Brignole ◽  
Carlo Menozzi ◽  
Lorella Gianfranchi ◽  
Daniele Oddone ◽  
Gino Lolli ◽  
...  

Biology ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 919
Author(s):  
Kengo Ayabe ◽  
Tomoyoshi Komiyama ◽  
Misaki Hasegawa ◽  
Tetsuri Sakai ◽  
Masahiro Morise ◽  
...  

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.


1998 ◽  
Vol 67 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Matı́as Pérez-Paredes ◽  
Francisco Picó-Aracil ◽  
Teo Fuentes-Jiménez ◽  
José G Sánchez-Villanueva ◽  
Elena Expósito-Ordoñez ◽  
...  

2012 ◽  
Vol 19 (04) ◽  
pp. 428-432
Author(s):  
HUMAIRA FAYYAZ KHAN ◽  
MUHAMMAD AMJAD HAMEED ◽  
KAMAL SALEEM ◽  
Ayyaz Ahmed ◽  
Nida Naeem

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251450
Author(s):  
Misaki Hasegawa ◽  
Tomoyoshi Komiyama ◽  
Kengo Ayabe ◽  
Susumu Sakama ◽  
Tetsuri Sakai ◽  
...  

We investigated circulatory dynamics in patients with vasodepressor type neurally mediated syncope (VT-NMS) by performing high-resolution Holter electrocardiography and a correlation analysis of changes in adenylate cyclase activity, blood pressure, and pulse during the head-up tilt test. Holter electrocardiography was performed for 30 patients. Adenylate cyclase activity was evaluated in lymphocytes from blood samples taken at rest and during the head-up tilt test. There was no change in autonomic nerve fluctuation during electrocardiography in VT-NMS patients, but our results showed a significant difference in blood pressure and adenylate cyclase activity between VT-NMS patients and healthy volunteers; the systolic blood pressure of VT-NMS patients decreased after 5 min, while at 10 min, the adenylate cyclase activity was the highest (0.53%) and the systolic blood pressure was the lowest (111.8 mm Hg). Pulse rates increased after 10 min. VT-NMS patients showed higher blood pressure, pulse rate, and adenylate cyclase activity during the tilt test than did healthy volunteers. In patients with syncope, standing for longer than 10 minutes may increase the risk of VT-NMS. From our results, we consider it likely that high systolic blood pressure and adenylate cyclase activity at rest cause fainting in VT-NMS patients. Our findings may be helpful for identifying individuals with a high risk of developing NMS in the healthy population.


1998 ◽  
Vol 18 (4) ◽  
pp. 424-432 ◽  
Author(s):  
Haruyuki Nakagawa ◽  
Youichi Kobayashi ◽  
Makoto Shinohara ◽  
Chiaki Obara ◽  
Akira Miyata ◽  
...  

2017 ◽  
Vol 40 (12) ◽  
pp. 1454-1461 ◽  
Author(s):  
Sung Ho Lee ◽  
Ji Hyun Yang ◽  
Hye Ran Yim ◽  
Jungwae Park ◽  
Seung-Jung Park ◽  
...  

1999 ◽  
Vol 22 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
MATIAS PEREZ-PAREDES ◽  
FRANCISCO PICO-ARACIL ◽  
RAFAEL FLORENCIANO ◽  
JOSE G. SANCHEZ-VILLANUEVA ◽  
JOSE ANTONIO RUIZ ROS ◽  
...  

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