Document Detail

Head-up tilt table testing with low dose sublingual isosorbide dinitrate in the evaluation of unexplained syncope: a comparison with isoproterenol infusion.
MedLine Citation:
PMID:  12215748     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the value of head-up tilt table testing (HUTT) with low-dose isosorbide dinitrate (ISDN) in the evaluation of patients with unexplained syncope and to compare the results of HUTT with ISDN and HUTT with isoproterenol. PATIENTS AND METHODS: Forty-three patients with unexplained syncope (21 women, with a mean age of 45.4 18 years) and 18 control subjects without syncope (eight women, with a mean age of 45.8 12 years) were tilted (80 ) for 30 min (passive period). When this period was negative, 2.5 mg sublingual ISDN was administered and patients were observed for an additional 15 min (ISDN period). The first 25 patients studied (10 women, with a mean age of 46.2 18 years) were tested again after a mean period of three weeks using the isoproterenol protocol. After the passive period, intravenous isoproterenol was administered (1 to 3 g/min) to patients lying in the supine position, and they were tilted again (80 ) for 10 min (isoproterenol period). RESULTS: During the passive period, 10 of 43 patients (23%) had a positive response compared with none in the control group. Syncope was observed in another 14 patients and in two control subjects during the ISDN period. The positivity rate (sensitivity) and specificity of HUTT with low dose ISDN were 56% and 89%, respectively. Among the patients (n=25) tested with the isoproterenol protocol, 14 (56%) patients had syncope. The agreement rate between the protocols was 78.9%. CONCLUSIONS: The total positivity rate of HUTT significantly increased with the use of the low dose ISDN, while specificity remained high. Due to its simplicity and tolerability, the ISDN protocol can be chosen when the results of the passive period tilt testing are negative.
Ozgur Aslan; Sema Guneri; Ozer Badak; Onder Kirimli; Ozhan Goldeli; Vehip Keskin; Bahri Akdeniz; Umit Tekin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  18     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-06     Completed Date:  2002-09-25     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  853-9     Citation Subset:  IM    
Department of Cardiology, Dokuz Eylül University, School of Medicine, Izmir, Turkey.
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MeSH Terms
Administration, Sublingual
Cardiovascular Agents / administration & dosage,  diagnostic use*
Infusions, Intravenous
Isoproterenol / diagnostic use*
Isosorbide Dinitrate / administration & dosage,  diagnostic use*
Middle Aged
Sensitivity and Specificity
Syncope / etiology*
Syncope, Vasovagal / diagnosis*
Tilt-Table Test / methods*
Reg. No./Substance:
0/Cardiovascular Agents; 7683-59-2/Isoproterenol; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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