Document Detail

Nitrate-potentiated head-up tilt testing in older patients: outcomes, hemodynamic responses and prodrome recognition.
MedLine Citation:
PMID:  20487350     Owner:  NLM     Status:  MEDLINE    
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.
Pietro Guida; Massimo Iacoviello; Cinzia Forleo; Sandro Sorrentino; Agata Puzzovivo; Marica Rodio; Francesca De Pascalis; Cataldo Balducci; Margherita Sarlo; Stefano Favale
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1210-6     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Cardiology Unit, Emergency and Organ Transplantation Department, University of Bari, Piazza Giulio Cesare 11, Bari, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Blood Pressure / drug effects
Heart Rate / drug effects,  physiology
Middle Aged
Nitrates / pharmacology*
Nitroglycerin / diagnostic use
Syncope, Vasovagal / diagnosis*,  epidemiology,  physiopathology*
Tilt-Table Test / methods*
Young Adult
Reg. No./Substance:
0/Nitrates; 55-63-0/Nitroglycerin

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

Previous Document:  The role of the selective serotonin re-uptake inhibitor sertraline in nondepressive patients with ch...
Next Document:  Rationale and design of the OPTION study: optimal antitachycardia therapy in ICD patients without pa...