Hemodynamic Response to the Head-Up Tilt Test in Patients With Syncope as a Predictor of the Test Outcome: A Meta-Analysis Approach

Buszko, Katarzyna; Kujawski, Sławomir; Newton, Julia L.; Zalewski, Paweł

doi:10.3389/fphys.2019.00184

Cited by 19 publications

(8 citation statements)

References 27 publications

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“…Therefore, we propose to include SV measurements as a standard tool for diagnosing VVS, along with ICG and blood pressure monitoring. This conclusion is in line with our previous analysis based on other entropy measures [ 17 , 39 , 40 , 41 ]. Others investigators arrived at similar conclusions based on the measurement of SV in the early tilt [ 42 ].…”

Section: Discussionsupporting

confidence: 92%

Transfer Information Assessment in Diagnosis of Vasovagal Syncope Using Transfer Entropy

Buszko

Piątkowska

Koźluk

et al. 2019

Entropy

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The paper presents an application of Transfer Entropy (TE) to the analysis of information transfer between biosignals (heart rate expressed as R-R intervals (RRI), blood pressure (sBP, dBP) and stroke volume (SV)) measured during head up tilt testing (HUTT) in patients with suspected vasovagal syndrome. The study group comprised of 80 patients who were divided into two groups: the HUTT(+) group consisting of 57 patients who developed syncope during the passive phase of the test and HUTT(−) group consisting of 23 patients who had a negative result of the passive phase and experienced syncope after provocation with nitroglycerin. In both groups the information transfer depends on the phase of the tilt test. In supine position the highest transfer occurred between driver RRI and other components. In upright position it is the driver sBP that plays the crucial role. The pre-syncope phase features the highest information transfer from driver SV to blood pressure components. In each group the comparisons of TE between different phases of HUT test showed significant differences for RRI and SV as drivers.

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Section: Discussionsupporting

confidence: 92%

Transfer Information Assessment in Diagnosis of Vasovagal Syncope Using Transfer Entropy

Buszko

Piątkowska

Koźluk

et al. 2019

Entropy

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“…reduced venous return and cardiac filling. Combination of lower circulating blood volume and excessive blood pooling in capacitance vessels during orthostatic challenge may abruptly reduce stroke volume during TT, with a compensatory HR increase, as shown by Buszko et al 19 .…”

Section: Discussionmentioning

confidence: 90%

Underlying hemodynamic differences are associated with responses to tilt testing

Fedorowski

Rivasi

Torabi

et al. 2021

Sci Rep

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Aim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients considered likely to be of vasovagal reflex etiology, comparing patients who had tilt-induced reflex response with those who did not. Tilt-induced reflex response was defined as spontaneous symptom reproduction with characteristic hypotension and bradycardia. Relationship of demographics and baseline supine BP to tilt-test were assessed using logistic regression models. Individual records of 5236 patients (45% males; mean age: 60 ± 22 years; 32% prescribed antihypertensive therapy) were analyzed. Tilt-positive (n = 3129, 60%) vs tilt-negative patients had lower SBP (127.2 ± 17.9 vs 129.7 ± 18.0 mmHg, p < 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p < 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p < 0.001). In multivariable analyses, tilt-test positivity was independently associated with younger age (Odds ratio (OR) per 10 years:1.04; 95% confidence interval (CI), 1.01–1.07, p = 0.014), SBP ≤ 128 mmHg (OR:1.27; 95%CI, 1.11–1.44, p < 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17–1.50, p < 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38–1.81, p < 0.001). In conclusion, among patients with suspected reflex syncope, younger age, lower blood pressure and lower heart rate are associated with positive tilt-test result.

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“…Clinical studies show that in healthy individuals, excessive activation of sympathetic and inhibition of parasympathetic effects on the cardiovascular system in the first five minutes of orthostasis are the predictors of vasovagal syncope development during tilt testing (11,12). Therefore, in young males with AH during an active orthostatic test, the response of spectral indices of HRV was similar to the patients with vasovagal syncope, indicating the presence of vegetative imbalance in patients with AH.…”

Section: Discussionmentioning

confidence: 95%

Prognosis of the development of orthostatic hypotension in young males with hypertension

Біловол¹,

Kniazkova²,

Bogun³

2019

Medicinski časopis

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Objective. The aim of the study was to improve the prognosis of orthostatic hypotension (OH) in young males with hypertension (AH) during antihypertensive therapy. Methods. Total of 62 male patients were examined, mean age 31.5 ± 3.6 years with AH of the 1 st and 2 nd degrees. The control group consisted of 20 practically healthy persons (mean age 31.0 ± 3.7 years). All patients underwent general clinical examination, measurement of office blood pressure (BP), daily monitoring of BP with the help of the ABPM-02 device (Meditech, Hungary), active orthostatic test (AOT) with determination of the Kerdo vegetative index (KI). During AOT, ECG and heart rate variability (HRV) were monitored according to the conventional methodology using monitors CardioTens-01 ("Meditech", Hungary). All patients underwent antihypertensive therapy. In 80.6% of patients, AH was controlled with drugs. Zaključak. Prognoza razvoja OH u slučaju AH kod mladih pacijenata omogucíće efikasniju korekciju BP u određenoj grupi pacijenata.

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Hemodynamic Response to the Head-Up Tilt Test in Patients With Syncope as a Predictor of the Test Outcome: A Meta-Analysis Approach

Cited by 19 publications

References 27 publications

Transfer Information Assessment in Diagnosis of Vasovagal Syncope Using Transfer Entropy

Transfer Information Assessment in Diagnosis of Vasovagal Syncope Using Transfer Entropy

Underlying hemodynamic differences are associated with responses to tilt testing

Prognosis of the development of orthostatic hypotension in young males with hypertension

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