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- Title
Predictors of Response to the Head-Up Tilt Test in Patients with Unexplained Syncope or Presyncope.
- Authors
KAZEMI, BABAK; HAGHJOO, MAJID; ARYA, ARASH; SADR‐AMELI, MOHAMMAD ALI
- Abstract
Background: Unexplained syncope is a relatively frequent symptom, mostly caused by a neurocardiogenic reaction. The purpose of this study was to determine predictors of response to head-up tilt testing (HUTT) in patients with unexplained syncope or presyncope. Methods: HUTT was done in 640 consecutive patients with unexplained syncope or presyncope (393 men, mean age 45± 19 years) after initial workup including history, physical examination, and appropriate laboratory evaluation. Results: Three hundred and forty-four (54%) patients had a positive result. The most common type of response was mixed type (46%) followed by vasodepressor (39%) and cardioinhibitory (15%) types. Age, gender, presence of structural heart disease, baseline heart rhythm, and the presenting symptom before the test failed to predict a positive response to HUTT, but among patients with a positive response to the test, age (OR: 1.54, CI = 1.04–2.47, P = 0.016) and presyncope (OR: 2.16, CI = 1.2–3.85, P = 0.008) as the presenting symptom predicted a vasodepressor type of response. The age (OR: 1.58, CI = 1.29–3.94, P = 0.01) and presyncope (OR: 4.6, CI = 1.74–12.24, P = 0.001) were also predictors for test positivity in the active stage. Conclusions: There is an age-related gradient in hemodynamic response during neurocardiogenic syncope. The elderly patients more commonly had a vasodepressor and late response, in the active stage, but young subjects more commonly experienced an earlier and cardioinhibitory or mixed responses in the passive stage.
- Subjects
SYNCOPE; AGE; GENDER; HEMODYNAMICS; LOSS of consciousness
- Publication
Pacing & Clinical Electrophysiology, 2006, Vol 29, Issue 8, p846
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2006.00450.x