Underlying hemodynamic differences are associated with responses to tilt testing
Abstract Aim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients co...
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Nature Portfolio
2021
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oai:doaj.org-article:fa061eb26f0342b8b1dedd70656c24f52021-12-02T17:41:12ZUnderlying hemodynamic differences are associated with responses to tilt testing10.1038/s41598-021-97503-02045-2322https://doaj.org/article/fa061eb26f0342b8b1dedd70656c24f52021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97503-0https://doaj.org/toc/2045-2322Abstract Aim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients considered likely to be of vasovagal reflex etiology, comparing patients who had tilt-induced reflex response with those who did not. Tilt-induced reflex response was defined as spontaneous symptom reproduction with characteristic hypotension and bradycardia. Relationship of demographics and baseline supine BP to tilt-test were assessed using logistic regression models. Individual records of 5236 patients (45% males; mean age: 60 ± 22 years; 32% prescribed antihypertensive therapy) were analyzed. Tilt-positive (n = 3129, 60%) vs tilt-negative patients had lower SBP (127.2 ± 17.9 vs 129.7 ± 18.0 mmHg, p < 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p < 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p < 0.001). In multivariable analyses, tilt-test positivity was independently associated with younger age (Odds ratio (OR) per 10 years:1.04; 95% confidence interval (CI), 1.01–1.07, p = 0.014), SBP ≤ 128 mmHg (OR:1.27; 95%CI, 1.11–1.44, p < 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17–1.50, p < 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38–1.81, p < 0.001). In conclusion, among patients with suspected reflex syncope, younger age, lower blood pressure and lower heart rate are associated with positive tilt-test result.Artur FedorowskiGiulia RivasiParisa TorabiMadeleine JohanssonMartina RafanelliIrene MarozziAlice CeccofiglioNiccolò CasiniViktor HamreforsAndrea UngarBrian OlshanskyRichard SuttonMichele BrignoleGianfranco ParatiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021) |
| institution |
DOAJ |
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DOAJ |
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EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Artur Fedorowski Giulia Rivasi Parisa Torabi Madeleine Johansson Martina Rafanelli Irene Marozzi Alice Ceccofiglio Niccolò Casini Viktor Hamrefors Andrea Ungar Brian Olshansky Richard Sutton Michele Brignole Gianfranco Parati Underlying hemodynamic differences are associated with responses to tilt testing |
| description |
Abstract Aim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients considered likely to be of vasovagal reflex etiology, comparing patients who had tilt-induced reflex response with those who did not. Tilt-induced reflex response was defined as spontaneous symptom reproduction with characteristic hypotension and bradycardia. Relationship of demographics and baseline supine BP to tilt-test were assessed using logistic regression models. Individual records of 5236 patients (45% males; mean age: 60 ± 22 years; 32% prescribed antihypertensive therapy) were analyzed. Tilt-positive (n = 3129, 60%) vs tilt-negative patients had lower SBP (127.2 ± 17.9 vs 129.7 ± 18.0 mmHg, p < 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p < 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p < 0.001). In multivariable analyses, tilt-test positivity was independently associated with younger age (Odds ratio (OR) per 10 years:1.04; 95% confidence interval (CI), 1.01–1.07, p = 0.014), SBP ≤ 128 mmHg (OR:1.27; 95%CI, 1.11–1.44, p < 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17–1.50, p < 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38–1.81, p < 0.001). In conclusion, among patients with suspected reflex syncope, younger age, lower blood pressure and lower heart rate are associated with positive tilt-test result. |
| format |
article |
| author |
Artur Fedorowski Giulia Rivasi Parisa Torabi Madeleine Johansson Martina Rafanelli Irene Marozzi Alice Ceccofiglio Niccolò Casini Viktor Hamrefors Andrea Ungar Brian Olshansky Richard Sutton Michele Brignole Gianfranco Parati |
| author_facet |
Artur Fedorowski Giulia Rivasi Parisa Torabi Madeleine Johansson Martina Rafanelli Irene Marozzi Alice Ceccofiglio Niccolò Casini Viktor Hamrefors Andrea Ungar Brian Olshansky Richard Sutton Michele Brignole Gianfranco Parati |
| author_sort |
Artur Fedorowski |
| title |
Underlying hemodynamic differences are associated with responses to tilt testing |
| title_short |
Underlying hemodynamic differences are associated with responses to tilt testing |
| title_full |
Underlying hemodynamic differences are associated with responses to tilt testing |
| title_fullStr |
Underlying hemodynamic differences are associated with responses to tilt testing |
| title_full_unstemmed |
Underlying hemodynamic differences are associated with responses to tilt testing |
| title_sort |
underlying hemodynamic differences are associated with responses to tilt testing |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/fa061eb26f0342b8b1dedd70656c24f5 |
| work_keys_str_mv |
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