open access

Vol 63, No 9 (2005)
Other
Published online: 2005-09-21
Submitted: 2012-12-28
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ORIGINAL ARTICLE
Haemodynamic indices of the early phase of the tilt test: does measurement predict outcome?

Grzegorz Gielerak, Przemysław Guzik, Karol Makowski, Jarosław Kowal, Marian Cholewa
Kardiol Pol 2005;63(9):244-251.

open access

Vol 63, No 9 (2005)
Other
Published online: 2005-09-21
Submitted: 2012-12-28

Abstract

Introduction: Tilt testing (TT) is a well-established tool in the diagnosis of syncope. However, it is time-consuming. Therefore, identification of parameters that could shorten the duration of TT is desirable. Aim: To identify and assess the usefulness of early haemodynamic parameter changes in prediction of the tilt test results in a group of patients with syncope of unknown aetiology. Methods: The study involved a group of 105 patients, including 61 women and 44 men, with a mean age of 34.2±13.7 (from 13 to 82) years, with at least two episodes of syncope in the last 6 months. The head-up tilt test was carried out according to protocol 60/20 min and if necessary was continued after administration of sublingual nitroglycerine in a dose of 250 g. The assessment of haemodynamic indices was performed employing the beat-to-beat method using the Portapres M2 device. Systolic (SBP) and diastolic (DBP) arterial pressure, heart rate (HR), cardiac output (CO) and stroke volume (SV), and total peripheral vascular resistance (TPR) were analysed. The measured values of haemodynamic indices were calculated by means of averaging 10-second intervals within 3-minute studied periods either before or after tilting a patient. Mean baroreceptor sensitivity (BRS) for the same 3-minute-long intervals was evaluated using the xBRS (cross-correlation) method. In the analysis, differences (Rx) of the haemodynamic values between the beginning of tilting a patient and the rest period were also calculated. Results: Loss of consciousness was noted in 47 (46%) of the studied patients – group I. The remaining subjects (58 patients, 54%) did not develop syncope during TT (group II). The univariate and multivariate logistic analyses of regression revealed that the mean vascular resistance difference (meanRTPR)

Abstract

Introduction: Tilt testing (TT) is a well-established tool in the diagnosis of syncope. However, it is time-consuming. Therefore, identification of parameters that could shorten the duration of TT is desirable. Aim: To identify and assess the usefulness of early haemodynamic parameter changes in prediction of the tilt test results in a group of patients with syncope of unknown aetiology. Methods: The study involved a group of 105 patients, including 61 women and 44 men, with a mean age of 34.2±13.7 (from 13 to 82) years, with at least two episodes of syncope in the last 6 months. The head-up tilt test was carried out according to protocol 60/20 min and if necessary was continued after administration of sublingual nitroglycerine in a dose of 250 g. The assessment of haemodynamic indices was performed employing the beat-to-beat method using the Portapres M2 device. Systolic (SBP) and diastolic (DBP) arterial pressure, heart rate (HR), cardiac output (CO) and stroke volume (SV), and total peripheral vascular resistance (TPR) were analysed. The measured values of haemodynamic indices were calculated by means of averaging 10-second intervals within 3-minute studied periods either before or after tilting a patient. Mean baroreceptor sensitivity (BRS) for the same 3-minute-long intervals was evaluated using the xBRS (cross-correlation) method. In the analysis, differences (Rx) of the haemodynamic values between the beginning of tilting a patient and the rest period were also calculated. Results: Loss of consciousness was noted in 47 (46%) of the studied patients – group I. The remaining subjects (58 patients, 54%) did not develop syncope during TT (group II). The univariate and multivariate logistic analyses of regression revealed that the mean vascular resistance difference (meanRTPR)
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Keywords

vasovagal syncope; systemic vascular resistance; tilt test

About this article
Title

ORIGINAL ARTICLE
Haemodynamic indices of the early phase of the tilt test: does measurement predict outcome?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 63, No 9 (2005)

Pages

244-251

Published online

2005-09-21

Bibliographic record

Kardiol Pol 2005;63(9):244-251.

Keywords

vasovagal syncope
systemic vascular resistance
tilt test

Authors

Grzegorz Gielerak
Przemysław Guzik
Karol Makowski
Jarosław Kowal
Marian Cholewa

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