| Nitrate-potentiated head-up tilt testing in older patients: outcomes, hemodynamic responses and prodrome recognition. | |
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MedLine Citation:
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PMID: 20487350 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To compare head-up tilt testing (HUT) outcomes and hemodynamic responses, and the prevalence and correlates of prodromes, in elderly and younger patients with suspected vasovagal syncope (VVS). METHODS: Consecutive outpatients with a history of recurrent unexplained syncope underwent HUT by being tilted to 70°; the test was potentiated by the administration of 300 μg of nitroglycerine after 20 minutes. Occurrence of VVS and hemodynamic responses during passive and nitroglycerine phases of HUT were evaluated; symptoms preceding HUT-induced syncope were recorded, together with heart rate and arterial blood pressure values. RESULTS: Four hundred and sixty of the 743 patients were HUT positive: 156 fainted during the unmedicated phase and 304 after nitroglycerine administration. The patients aged ≥65 years (n = 102) experienced VVS more frequently during the pharmacological stage of HUT; the overall rate of positive results was similar to that observed in the patients aged 36-64 years (n = 329) and only slightly lower than that observed in those aged ≤ 35 years (n = 312). In the older patients, who experienced fewer and mainly prodrome-free spontaneous syncopal episodes, HUT increased the number of premonitory symptoms, and there were no significant age-related differences in symptom prevalence or timing or the patients' hemodynamic characteristics. CONCLUSIONS: The rate of VVS induced by nitroglycerine-potentiated HUT is similar in elderly and younger patients. In the former, nitroglycerine-potentiated HUT significantly increases the prevalence of prodromes in comparison with spontaneous episodes, which suggests that it may be useful not only for diagnosis but also for patient counseling. |
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Authors:
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Pietro Guida; Massimo Iacoviello; Cinzia Forleo; Sandro Sorrentino; Agata Puzzovivo; Marica Rodio; Francesca De Pascalis; Cataldo Balducci; Margherita Sarlo; Stefano Favale |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 33 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-30 Completed Date: 2011-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1210-6 Citation Subset: IM |
Copyright Information:
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©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc. |
Affiliation:
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Cardiology Unit, Emergency and Organ Transplantation Department, University of Bari, Piazza Giulio Cesare 11, Bari, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Blood Pressure / drug effects Female Heart Rate / drug effects, physiology Hemodynamics* Humans Male Middle Aged Nitrates / pharmacology* Nitroglycerin / diagnostic use Prevalence Syncope, Vasovagal / diagnosis*, epidemiology, physiopathology* Tilt-Table Test / methods* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Nitrates; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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