Clinical features and response at head-up tilt test of patients with situational syncope

被引:9
作者
Russo, Vincenzo [1 ,3 ]
Parente, Erika [1 ]
Comune, Angelo [1 ]
Laezza, Nunzia [1 ]
Rago, Anna [1 ]
Nigro, Gerardo [1 ]
Brignole, Michele [2 ]
机构
[1] Univ Campania Luigi Vanvitelli, Monaldi Hosp, Dept Translat Med Sci, Cardiol & Syncope Unit, Naples, Italy
[2] Ospedali Tigullio, Cardiology, Lavagna, Italy
[3] Univ Campania Luigi Vanvitelli, Monaldi Hosp, Dept Translat Med Sci, Cardiol & Syncope Unit, Naples, Campania, Italy
关键词
arrhythmias; cardiac; VASOVAGAL SYNCOPE; NITROGLYCERIN; ORIGIN;
D O I
10.1136/heartjnl-2023-322943
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveThe study compared clinical characteristics and response at head-up tilt test (HUTT) between situational (SS) and vasovagal syncope (VVS). MethodsConsecutive patients who underwent nitroglycerin-potentiated HUTT were retrospectively dichotomised into two groups: those with a history of SS and those with a history of VVS. The patients with SS were further subdivided into patients with SS alone and with SS and at least one episode of VVS. Results1285 patients were enrolled: 246 (19.1%) had SS (SS alone in 121 and SS+VVS in 125). Patients with SS were older (48.8 & PLUSMN;20.0 vs 44.4 & PLUSMN;19.1, p=0.007) and more frequently male (57.3% vs 47.7%, p=0.001). At multivariable analysis, smoking habit (OR 2.28; p<0.0001), history of traumatic syncope (OR 2.29; p=0.0001) and ACE inhibitors/angiotensin II receptor blockers (OR 4.74; p<0.0001) were independently associated with SS. HUTT was positive in 175 (71.1%) patients with SS and in 737 (70.9%) patients with VVS (p=0.9). Patients with SS showed more mixed (42.3% vs 32.0%, p=0.002) and vasodepressor forms (10.6% vs 6.1%, p=0.01) and less cardioinhibitory responses compared with others (18.3% vs 32.8%, p<0.0001). ConclusionsCompared with VVS, patients with SS have different clinical characteristics and a higher prevalence of hypotensive drugs leading to hypotensive susceptibility. The positivity rate of HUTT is high and similar to that of VVS, although patients with SS show a higher prevalence of hypotensive responses.
引用
收藏
页码:35 / 39
页数:5
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[31]   The Differences in the Diagnostic Profile in Children with Vasovagal Syncope between the Result of Head-Up Tilt Table Test [J].
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