Clinical predictors of head-up tilt test outcome during the nitroglycerin phase. Export

@article{citeulike:5111159, abstract = {OBJECTIVES: Nitrate-stimulated head-up tilt testing (HUT) is currently recommended to confirm the diagnosis of vasovagal syncope in subjects with syncope of unknown origin. Given the few data currently available, the aim of this study was to assess correlations between nitrate-induced HUT outcomes and the clinical characteristics of patients. METHODS: Two hundred and thirty consecutive, otherwise healthy subjects with a history of recurrent unexplained syncope underwent HUT. After 10 min supine rest, they were tilted to 70 degrees , and the test was potentiated by the administration of 300 mug of nitroglycerin after 20 min. RESULTS: Out of 178 subjects who underwent nitroglycerin administration during HUT, 95 fainted. At univariate Cox regression analysis, a reduced probability of VVS occurrence after nitrates was associated with greater systolic blood pressure and body mass index values, to male gender and smoking. At multivariate Cox regression analysis, only male gender (HR = 0.61; P = 0.039) and smoking (HR = 0.18; P = 0.001) remained significantly associated with HUT outcomes during the pharmacological phase of the test. INTERPRETATION: Smokers and males are less likely to faint after nitrate administration during HUT than non-smokers and females. Further studies should clarify the possibility of improving the diagnostic power of HUT in these patients.}, author = {Iacoviello, Massimo and Forleo, Cinzia and Guida, Pietro and Ciccone, Marco M. and Sorrentino, Sandro and D'Andria, Valentina and Panunzio, Mariligia and Favale, Stefano}, citeulike-article-id = {5111159}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s10286-009-0020-7}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19565320}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19565320}, citeulike-linkout-3 = {http://www.springerlink.com/content/1126360j02622mp5}, day = {30}, doi = {10.1007/s10286-009-0020-7}, issn = {1619-1560}, journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society}, keywords = {diagnosis, hut}, month = {June}, posted-at = {2009-08-14 13:33:22}, priority = {2}, title = {Clinical predictors of head-up tilt test outcome during the nitroglycerin phase.}, url = {http://dx.doi.org/10.1007/s10286-009-0020-7}, year = {2009} }

TY - JOUR ID - citeulike:5111159 L3 - citeulike-article-id:5111159 N2 - OBJECTIVES: Nitrate-stimulated head-up tilt testing (HUT) is currently recommended to confirm the diagnosis of vasovagal syncope in subjects with syncope of unknown origin. Given the few data currently available, the aim of this study was to assess correlations between nitrate-induced HUT outcomes and the clinical characteristics of patients. METHODS: Two hundred and thirty consecutive, otherwise healthy subjects with a history of recurrent unexplained syncope underwent HUT. After 10 min supine rest, they were tilted to 70 degrees , and the test was potentiated by the administration of 300 mug of nitroglycerin after 20 min. RESULTS: Out of 178 subjects who underwent nitroglycerin administration during HUT, 95 fainted. At univariate Cox regression analysis, a reduced probability of VVS occurrence after nitrates was associated with greater systolic blood pressure and body mass index values, to male gender and smoking. At multivariate Cox regression analysis, only male gender (HR = 0.61; P = 0.039) and smoking (HR = 0.18; P = 0.001) remained significantly associated with HUT outcomes during the pharmacological phase of the test. INTERPRETATION: Smokers and males are less likely to faint after nitrate administration during HUT than non-smokers and females. Further studies should clarify the possibility of improving the diagnostic power of HUT in these patients. JF - Clinical autonomic research : official journal of the Clinical Autonomic Research Society SN - 1619-1560 TI - Clinical predictors of head-up tilt test outcome during the nitroglycerin phase. KW - diagnosis KW - hut AU - Iacoviello, Massimo AU - Forleo, Cinzia AU - Guida, Pietro AU - Ciccone, Marco AU - Sorrentino, Sandro AU - D'Andria, Valentina AU - Panunzio, Mariligia AU - Favale, Stefano PY - 2009/06/30/ UR - http://dx.doi.org/10.1007/s10286-009-0020-7 ER -