Correlation between results of head-up tilt test and clinical features in patients with syncope or presyncope

Background: Head-up tilt test (HUTT) is a well-established diagnostic too] in patients with suspected vasovagal syncope. Identification of factors that predict a positive HUTT result could simplify diagnostic steps. T he aim of this study was to assess the con-elation between clinical characteristics of patients with suspected neurocardiogenic syncope or presyncope and results of HUTT. Materials and Methods: The study group consisted of 90 patients (55 men, 35 women; mean age, 43.2 +/- 17 years) with a history of syncope or presyncope. Cardiological and neurologic test findings were normal in every patient. The patients were tilted to a 70 degrees position for 45 minutes. If the first phase produced a negative response, the patients received 400 ig of sublingual nitroglycerin for the second phase and continued to be tilted for an additional 15 minutes. Results: Sixty-four patients bad a positive HUTT result, characterized by a vasodepressive response in 26 patients, mixed response in 24 patients, and cardioinhibitory response in 14 patients. In logistic regression analysis, the presence of prodromal symptoms was a predictor of a positive HUTT result (P =.002). Conclusion: We showed that the prognostic performance of clinical features, including the time interval between the last episode and HUTT, the number of syncope or presyncope episodes, age, and sex, was not: ideal. The presence of prodromal symptoms might be more likely to predict a positive response during HUTT. (c) 2007 Elsevier Inc. All rights reserved.