Syncope as a health risk for soldiers - influence of medical history and clinical findings on the sensitivity of head-up tilt table testing

被引:5
作者
Gilfrich H.-J. [1 ]
Heidelmann L.M. [2 ]
Grube F. [2 ]
Frickmann H. [3 ,4 ]
Jungblut S.A. [1 ]
机构
[1] The Practice of Dr. Jungblut, Frankfurt/Main
[2] The Flight Medicine Clinic at Fassberg, German Armed Forces, Faßberg
[3] The Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Hamburg
[4] University Medicine Rostock, The Department of Microbiology, Virology and Hygiene, Rostock
关键词
Assessment; Head-up tilt testing; Hypotension; Predictor; Soldiers; Syncope;
D O I
10.1186/s40779-015-0062-1
中图分类号
学科分类号
摘要
Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope. Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the electrocardiogram (ECG) patterns of patients showing syncope during tilt table testing. Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope. © 2015 Gilfrich et al.
引用
收藏
相关论文
共 50 条
  • [31] Reproducibility of sequential head-up tilt testing in patients with recent syncope, normal ECG and no structural heart disease
    Sagristà-Sauleda, J
    Romero, B
    Permanyer-Miraida, G
    Moya, A
    Soler-Soler, J
    EUROPEAN HEART JOURNAL, 2002, 23 (21) : 1706 - 1713
  • [32] Head-up tilt testing with different nitroglycerin dosages: experience in elderly patients with unexplained syncope
    Timoteo, Ana Teresa
    Oliveira, Mario Martins
    Feliciano, Joana
    Antunes, Eduardo
    da Silva, Manuel Nogueira
    Silva, Sofia
    Santos, Sofia
    Ferreira, Rui
    EUROPACE, 2008, 10 (09): : 1091 - 1094
  • [33] Clinical characteristics and head-up tilt test results with three protocols in 1661 patients with syncope
    Barón-Esquivias, G
    Cayuela, A
    Pedrote, A
    Cabezón, S
    Morán, JE
    Errázquin, F
    REVISTA ESPANOLA DE CARDIOLOGIA, 2003, 56 (09): : 916 - 920
  • [34] Heart rate variability during head-up tilt testing in patients with suspected neurally mediated syncope
    Grimm, W
    Wirths, A
    Hoffmann, J
    Menz, V
    Maisch, B
    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1998, 21 (11): : 2411 - 2415
  • [35] Clinical Significance of the Head-Up Tilt Test in Improving Prognosis in Patients with Possible Neurally Mediated Syncope
    Ayabe, Kengo
    Komiyama, Tomoyoshi
    Hasegawa, Misaki
    Sakai, Tetsuri
    Morise, Masahiro
    Sakama, Susumu
    Yagishita, Atsuhiko
    Amino, Mari
    Ikari, Yuji
    Yoshioka, Koichiro
    BIOLOGY-BASEL, 2021, 10 (09):
  • [36] Usefulness and safety of shortened head-up tilt testing potentiated with sublingual glyceryl trinitrate in older patients with recurrent unexplained syncope
    Del Rosso, A
    Ungar, A
    Bartoli, P
    Cellai, T
    Mussi, C
    Marchionni, N
    Masotti, G
    JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2002, 50 (08) : 1324 - 1328
  • [37] The benefit of closed loop stimulation in patients with cardioinhibitory vasovagal syncope confirmed by head-up tilt table testing: a systematic review and meta-analysis
    Mohammed Ruzieh
    Mehrdad Ghahramani
    Matthew Nudy
    Gerald V. Naccarelli
    John Mandrola
    Blair P. Grubb
    Andrew J. Foy
    Journal of Interventional Cardiac Electrophysiology, 2019, 55 : 105 - 113
  • [38] The benefit of closed loop stimulation in patients with cardioinhibitory vasovagal syncope confirmed by head-up tilt table testing: a systematic review and meta-analysis
    Ruzieh, Mohammed
    Ghahramani, Mehrdad
    Nudy, Matthew
    Naccarelli, Gerald V.
    Mandrola, John
    Grubb, Blair P.
    Foy, Andrew J.
    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2019, 55 (01) : 105 - 113
  • [39] Differences in heart rate variability between cardioinhibitory and vasodepressor responses to head-up tilt table testing
    Guzmán, CE
    Sánchez, GM
    Márquez, MF
    Hermosillo, AG
    Cárdenas, M
    ARCHIVES OF MEDICAL RESEARCH, 1999, 30 (03) : 203 - 211
  • [40] Early heart rate variations during head-up tilt table testing as a predictor of outcome of the test
    Alvarez, JB
    Asensio, E
    Lozano, JE
    Alvarez, M
    Portos, JM
    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 2000, 23 (01): : 26 - 31