Association of serotonin levels in patients of vasovagal syncope and postural tachycardia syndrome

2021 ◽  
pp. 1-10
Author(s):  
Hammad Raziq ◽  
Humaira Fayyaz ◽  
Rabia Azhar ◽  
Azmat Hayyat ◽  
Sobia Waqas
Keyword(s):  
Vasovagal Syncope ◽  
Test Method ◽  
Tilt Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Postural Tachycardia Syndrome ◽  
Postural Tachycardia ◽  
Group A ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Group B

Abstract Objective: To determine the level of serotonin in patients of vasovagal syncope and postural tachycardia syndrome after head-up tilt test. Method: The cross-sectional analytical study was conducted at the Islamic International Medical College and the Department of Electrophysiology, Armed Forces Institute of Cardiology, Rawalpindi, from April 2017 to March 2018. Group A comprised cases of vasovagal syncope, group B had patients of postural tachycardia syndrome, and group C had healthy controls. Cases were chosen on the basis of history, episodes of syncope and findings of head-up tilt test. After the test, blood samples were taken for hormonal analysis of serotonin using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Results: Of the 80 subjects, 35(43.8%) were in group A, 35(43.8%) in group B and 10(12.4%) in group C. Mean serotonin value in group A was 918.39±380.16nM, in group B it was 1188.70±449.55nM., while in control group C the mean value was 771.40±376.14nM (p<0.05)  Conclusion: Serotonin was found to have a significant role in syncope pathophysiology. Continuous...

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

2014 ◽  
Vol 24 (5) ◽  
pp. 792-796 ◽  
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.

Symptom Score: A New Instrument to Assess Orthostatic Intolerance in Children and Adolescents

2020 ◽  
Vol 35 (12) ◽  
pp. 835-843
Author(s):  
Hong Cai ◽  
Shuo Wang ◽  
Runmei Zou ◽  
Ping Liu ◽  
Hong Yang ◽  
...  
Keyword(s):  
Symptom Score ◽  
Orthostatic Intolerance ◽  
Vasovagal Syncope ◽  
Tilt Test ◽  
Postural Tachycardia Syndrome ◽  
Median Score ◽  
Postural Tachycardia ◽  
New Instrument ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Objective: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. Methods: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. Results: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min ( P < .01). Conclusions: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.

scholarly journals Comparison of the Active Sitting Test and Head-Up Tilt Test for Diagnosis of Postural Tachycardia Syndrome in Children and Adolescents

2021 ◽  
Vol 9 ◽  
Author(s):  
Hong Cai ◽  
Shuo Wang ◽  
Runmei Zou ◽  
Ping Liu ◽  
Fang Li ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Tilt Test ◽  
Postural Tachycardia Syndrome ◽  
Postural Change ◽  
Maximum Increase ◽  
Control Subjects ◽  
Postural Tachycardia ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
And Control

Objectives: We aimed to compare the hemodynamic responses to the active sitting test with the passive head-up tilt test (HUTT) in children and adolescents with postural tachycardia syndrome (POTS). We hypothesized that sitting tachycardia was also present in POTS patients during sitting.Materials and methods: We tested 30 POTS patients and 31 control subjects (mean age = 12 years, range = 9–16 years) who underwent both active sitting test and HUTT successively. We measured the heart rate (HR) and blood pressure (BP) during each test.Results: For both POTS patients and control subjects, the HUTT produced significantly larger HR and BP increases from 3 to 10 min of postural change than did the sitting test. Moreover, POTS patients with excessive orthostatic tachycardia during the HUTT also had significantly larger increases in HR at all test intervals during the sitting test than did the control subjects. A maximum increase in HR ≥ 22 bpm within 10 min of the sitting test was likely suggested to predict orthostatic tachycardia, yielding a sensitivity and specificity of 83.3 and 83.9%, respectively. Only six of 30 POTS patients (20%) reached the 40-bpm criterion during the sitting test, and no one complained of sitting intolerance symptoms.Conclusions: We have shown that POTS patients also have sitting tachycardia when changing from a supine position to a sitting position. We believe that the active sitting test is a reasonable alternative maneuver in assessing POTS in population groups that cannot tolerate the standing test or HUTT.

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

2005 ◽  
Vol 117 (9-10) ◽  
pp. 353-358 ◽  
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

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

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

scholarly journals Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Humaira Fayyaz ◽  
Shazadi Ambreen ◽  
Hammad Raziq ◽  
Azmat Hayyat
Keyword(s):  
Vasovagal Syncope ◽  
Serum Cortisol ◽  
Tilt Test ◽  
Control Group ◽  
Postural Tachycardia Syndrome ◽  
P Value ◽  
Cross Sectional ◽  
Postural Tachycardia ◽  
Significant Difference ◽  
Cortisol Levels

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

1990 ◽  
Vol 13 (11) ◽  
pp. 1416-1423 ◽  
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

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

2020 ◽  
Vol 17 (6) ◽  
pp. 1908 ◽  
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.

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