Predictive value of very low frequency at spectral analysis among patients with unexplained syncope assessed by head-up tilt testing

Ciliberti, Michela Anna Pia; Santoro, Francesco; Martino, Luigi Di; Rinaldi, Antonio Cosimo; Salvemini, Giuseppe; Cipriani, Francesco; Triggiani, Antonio Ivano; Moscatelli, Fiorenzo; Valenzano, Anna; Brunetti, Natale Daniele; Cibelli, Giuseppe

doi:10.1016/j.acvd.2017.04.006

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…According to them, a slight rise of HR (≤18 bpm) in the first 6 min indicates a negative HUT test result. Ciliberti et al (2018) compared HUT(+) patients with HUT(–). They found that very low frequency spectra component of heart rate during rest could be an independent predictor of syncope.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Aim: The paper presents a meta-analysis of studies comparing hemodynamic parameters: heart rate (HR), systolic blood pressure (sBP), diastolic blood pressure (dBP), and stroke volume (SV) measured during head-up tilt table test (HUTT) in patients with positive and negative HUT test outcome.Methods: Pubmed and Clinical Key databases were searched for English-only articles presenting results of biosignals measurements during tilt test in patients suffering from syncope. From 3,289 articles 13 articles published between 1997 and 2015 investigating 892 patients (467 with positive HUTT outcome and 401 with negative one) were selected.Results: There were not statistically significant differences observed between the parameters measured in supine position in patients with positive and negative test outcome [HR (p = 0.86), sBP (p = 0.32), dBP (p = 0.21), SV (p = 0.71)]. In tilt position the parameters HR and SV were significantly different when compared between the two groups of patients [HR (p = 0.02), sBP (p = 0.10), dBP (p = 0.59), SV (p = 0.0004)].Conclusions: Changes in HR and SV parameters in response to tilt test turned out to be statistically significant. In supine position the differences between patients with positive and negative test outcome were not significant, hence tilt test can be considered as necessary in the diagnosis of vasovagal syndrome.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…Heart rate variability (HRV) is an effective indicator of the activities of the autonomic nervous system (i.e., the balance between sympathetic and vagal activity) and is widely used to assess the autonomic response to various internal and external factors ( Acharya et al, 2006 ; von Borell et al, 2007 ; Billman, 2011 ). Indeed, the responses to a variety of physiological, psychological, and clinical factors such as exercise effects ( Pradhapan et al, 2014 ; Valenzano et al, 2016 ), anxiety ( Chalmers et al, 2014 ; Cotoia et al, 2018 ), and health conditions (e.g., cardiac diseases, Watanabe et al, 2017 ; Ciliberti et al, 2018 ; Sessa et al, 2018 ; viral infection, Carter et al, 2014 ; and obesity, Mehta, 2015 ; Messina et al, 2017 ; Triggiani et al, 2017 ) have been intensively investigated using HRV analysis in recent human studies. However, HRV is simultaneously affected by several interdependent physiological and environmental factors ( Fatisson et al, 2016 ) because the sinus node acts as the final summing element of stimuli from the sympathetic and vagal nerves, and their relationship is reflected in the actual heart inter-beat intervals ( Voss et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Correcting the Activity-Specific Component of Heart Rate Variability Using Dynamic Body Acceleration Under Free-Moving Conditions

et al. 2018

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Heart rate variability (HRV) analysis is a widely used technique to assess sympatho-vagal regulation in response to various internal or external stressors. However, HRV measurements under free-moving conditions are highly susceptible to subjects’ physical activity levels because physical activity alters energy metabolism, which inevitably modulates the cardiorespiratory system and thereby changes the sympatho-vagal balance, regardless of stressors. Thus, researchers must simultaneously quantify the effect of physical activity on HRV to reliably assess sympatho-vagal balance under free-moving conditions. In the present study, dynamic body acceleration (DBA), which was developed in the field of animal ecology as a quantitative proxy for activity-specific energy expenditure, was used as a factor to correct for physical activity when evaluating HRV in freely moving subjects. Body acceleration and heart inter-beat intervals were simultaneously measured in cattle and sheep, and the vectorial DBA and HRV parameters were evaluated at 5-min intervals. Next, the effects of DBA on the HRV parameters were statistically analyzed. The heart rate (HR) and most of the HRV parameters were affected by DBA in both animal species, and the inclusion of the effect of DBA in the HRV analysis greatly influenced the frequency domain and nonlinear HRV parameters. By removing the effect of physical activity quantified using DBA, we could fairly compare the stress levels of animals with different physical activity levels under different management conditions. Moreover, we analyzed and compared the HRV parameters before and after correcting for the mean HR, with and without inclusion of DBA. The results were somewhat unexpected, as the effect of DBA was a highly significant source of HRV also in parameters corrected for mean HR. In conclusion, the inclusion of DBA as a physical activity index is a simple and useful method for correcting the activity-specific component of HRV under free-moving conditions.

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“…However, further statistical differences in these indicators were not observed in different hemodynamic types of VVS. Ciliberti et al (19) observed that there was a significant statistical difference in VLF between the syncope and non-syncope groups in adults in the supine position (2421.09 ms 2 vs. 895.49 ms 2 , P < 0.01). According to the receiver operating characteristic (ROC) curve (AUC = 0.889), VLF > 2,048 ms 2 was recommended as the best cutoff value for predicting syncope during HUTT, and its sensitivity, specificity, positive predictive value, and negative predictive value were 87.5%, 72.2%, 75%, and 89%, respectively.…”

Section: Head-up Tilt Test and Heart Rate Variabilitymentioning

confidence: 95%

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope

Zhao

Wang²,

Wang³

et al. 2022

Front. Cardiovasc. Med.

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Neurally mediated syncope (NMS) is a common type of syncope in children in clinical practice, among which vasovagal syncope (VVS) is the most frequent. In recent years, more and more studies have been carried out to assess the diagnosis and prognosis of VVS. The electrocardiographic indicators such as heart rate variability (HRV), QT dispersion (QTd), P-wave dispersion (Pd), ventricular late potentials (VLP), deceleration ability of heart rate (DC), etc., are easy to obtain and inexpensive. With the help of electrocardiographic indicators, the diagnostic procedure and individualized treatment strategies of pediatric VVS can be optimized. This article reviews the value of electrocardiographic indicators in the diagnosis and prognosis of children with VVS.

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Predictive value of very low frequency at spectral analysis among patients with unexplained syncope assessed by head-up tilt testing

Abstract: VLF at rest predicted the incidence of syncope during HUTt. Further studies are warranted to confirm these preliminary data.

Cited by 11 publications

References 26 publications

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

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

Correcting the Activity-Specific Component of Heart Rate Variability Using Dynamic Body Acceleration Under Free-Moving Conditions

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope

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