Head-up tilt test diagnostic yield in syncope diagnosis
| Autor: | Carmen Barón-Solís, Macarena Quintanilla, Gonzalo Barón-Esquivias, Álvaro Marco del Castillo, Antonio J. Díaz Martín, Carlos A. Morillo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty 030204 cardiovascular system & hematology Single Center Syncope Electrocardiography 03 medical and health sciences Orthostatic vital signs Vasovagal 0302 clinical medicine Risk Factors Tilt-Table Test Clinical history Syncope Vasovagal medicine Humans In patient 030212 general & internal medicine Vasovagal syncope Aged Orthostatic hypotension biology business.industry Syncope (genus) Head up tilt Middle Aged biology.organism_classification medicine.disease Head-up tilt test Etiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 0022-0736 |
| DOI: | 10.1016/j.jelectrocard.2020.09.016 |
| Popis: | [Background] The European Syncope Guidelines (ESG) recommend the use of Head-up tilt test (HUT) in case of suspicion of vasovagal syncope (VVS) or orthostatic hypotensive syncope (OHS) after an adequate initial inconclusive evaluation. We report a single center experience in the scenario of suspected VVS or OHS, who underwent HUT in patients referred to a Syncope Clinic after ruling out high-risk causes. [Methods] We prospectively and consecutively included all syncopal patients that were referred for HUT, by their attending physician after performing a series of diagnostic tests to rule out cardiac etiology. The clinical history and diagnostic tests performed were reviewed prior to HUT. Patients were pre-classified according to the recommendations from the ESG as; VVS, OHS or Syncope of Unknown Etiology (SUE). [Results] We studied 1058 patients, 558 (52.7%) males, mean age 46.5 ± 20.1 yr. There were no gender differences in age, risk factors, previous heart diseases, ECG findings or number of previous tests. Based on the ESG criteria a significant number of diagnostic tests were probably unnecessarily performed. HUT was positive in 609 patients (57.5%). The rate of positive HUT according to pre-classification was significantly different among groups: 60% VVS, 46.1% OHS and 54.3% SUE (p = 0.037). Combining ESG recommendations and HUT results of the 1058 resulted in 762 (72%) diagnosed as VVS, 89 (8.4%) as OHS and 207 (19.5%) as SUE. [Conclusions] Appropriate application of ESG recommendations combined with HUT, identified 81% of patients with non-cardiogenic syncope, potentially avoiding a significant number of unnecessary diagnostic tests. |
| Databáze: | OpenAIRE |
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