Clinical features and response at head-up tilt test of patients with situational syncope.
Heart
; 110(1): 35-39, 2023 Dec 15.
Article
em En
| MEDLINE
| ID: mdl-37527918
ABSTRACT
OBJECTIVE:
The study compared clinical characteristics and response at head-up tilt test (HUTT) between situational (SS) and vasovagal syncope (VVS).METHODS:
Consecutive patients who underwent nitroglycerin-potentiated HUTT were retrospectively dichotomised into two groups those with a history of SS and those with a history of VVS. The patients with SS were further subdivided into patients with SS alone and with SS and at least one episode of VVS.RESULTS:
1285 patients were enrolled 246 (19.1%) had SS (SS alone in 121 and SS+VVS in 125). Patients with SS were older (48.8±20.0 vs 44.4±19.1, p=0.007) and more frequently male (57.3% vs 47.7%, p=0.001). At multivariable analysis, smoking habit (OR 2.28; p<0.0001), history of traumatic syncope (OR 2.29; p=0.0001) and ACE inhibitors/angiotensin II receptor blockers (OR 4.74; p<0.0001) were independently associated with SS. HUTT was positive in 175 (71.1%) patients with SS and in 737 (70.9%) patients with VVS (p=0.9). Patients with SS showed more mixed (42.3% vs 32.0%, p=0.002) and vasodepressor forms (10.6% vs 6.1%, p=0.01) and less cardioinhibitory responses compared with others (18.3% vs 32.8%, p<0.0001).CONCLUSIONS:
Compared with VVS, patients with SS have different clinical characteristics and a higher prevalence of hypotensive drugs leading to hypotensive susceptibility. The positivity rate of HUTT is high and similar to that of VVS, although patients with SS show a higher prevalence of hypotensive responses.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Síncope
/
Síncope Vasovagal
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article