Clinical Significance of the Head-Up Tilt Test in Improving Prognosis in Patients with Possible Neurally Mediated Syncope
| Autor: | Masahiro Morise, Koichiro Yoshioka, Tomoyoshi Komiyama, Yuji Ikari, Mari Amino, Susumu Sakama, Tetsuri Sakai, Kengo Ayabe, Misaki Hasegawa, Atsuhiko Yagishita |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
hypotension
medicine.medical_specialty sinoatrial node QH301-705.5 Biology Article General Biochemistry Genetics and Molecular Biology Tilt table test Orthostatic vital signs Interquartile range Internal medicine atrioventricular block medicine atrial fibrillation Clinical significance Biology (General) Vasovagal syncope tilt-table test General Immunology and Microbiology medicine.diagnostic_test Syncope (genus) food and beverages Retrospective cohort study biology.organism_classification medicine.disease vasovagal syncope Etiology General Agricultural and Biological Sciences |
| Zdroj: | Biology Volume 10 Issue 9 Biology, Vol 10, Iss 919, p 919 (2021) |
| ISSN: | 2079-7737 |
| Popis: | Syncope is commonly encountered in daily clinical practice. Depending on its etiology (benign or life-threatening conditions or environmental triggers), syncope can be neurally mediated (reflex), cardiac, or orthostatic. Furthermore, neurologic disease can cause symptoms that mimic syncope. However, there is limited research on neurally mediated syncope (NMS), which is considered a benign disorder, and close follow-ups are rarely performed. NMS can cause serious clinical events, including severe trauma and car accidents. The head-up tilt test (HUTT) is the gold standard for diagnosing NMS however, its clinical significance remains unknown, and its relevance to NMS prognosis requires further research. This retrospective study aimed to assess the clinical significance of the HUTT for NMS. We reviewed the charts of 101 patients who underwent HUTT at Tokai University Hospital in Japan between January 2016 and March 2019. During the HUTT, 72 patients (69.2%) experienced syncope. Patients were followed up for 886.1 ± 457.7 days (interquartile range: 518–1293 days). The syncope recurrence rate was 16.9% however, no significant difference was observed between the two groups (HUTT positive vs. negative) (13.8% vs. 18.1%, p = 0.772). Four of 29 (13.9%) and two of 72 (2.8%) patients in the negative and positive HUTT groups, respectively, experienced cardiac events (p = 0.019). Negative HUTT results may assist in anticipating unexpected clinical events within a few years. A negative HUTT result may allow us to reconsider the NMS diagnosis based on clinical information. Close outpatient follow-up of patients with negative HUTT results is warranted. |
| Databáze: | OpenAIRE |
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