Immediate reproducibility of the tilt-table test in adults with unexplained syncope

Immediate reproducibility of the tilt-table test in adults with unexplained syncope

There are few data regarding the immediate reproducibility of the tilt-table test (TTT). Therefore, the immediate reproducibility of the TTT was examined in 19 patients (11 men and 8 women; mean age 49 ± 19 years) with syncope or presyncope. The mean number of episodes that patients had experienced...

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Bibliographic Details
Published in:The American journal of cardiology Vol. 71; no. 4; pp. 304 - 307
Main Authors: de Buitleir, Michael, Grogan, E.Wayne, Picone, Mark F., Casteen, John A.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-02-1993
Elsevier
Elsevier Limited
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Blood Pressure - drug effects
Chi-Square Distribution
Chronic Disease
Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction
Female
Heart
Heart Rate - drug effects
Humans
Isoproterenol - administration & dosage
Male
Medical research
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Posture - physiology
Recurrence
Reproducibility of Results
Space life sciences
Syncope - diagnosis
Syncope - drug therapy
Syncope - epidemiology
Syncope - physiopathology
Tests
Time Factors
Heart
Human
Clinical test
Pharmacologic test
Nervous system diseases
Consciousness impairment
Exploration
Sympathomimetic
Vasovagal syncope
Tilt table
Reproducibility
Diseases of the autonomic nervous system
Adult
Hemodynamics
Neurological disorder
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Description
Summary:There are few data regarding the immediate reproducibility of the tilt-table test (TTT). Therefore, the immediate reproducibility of the TTT was examined in 19 patients (11 men and 8 women; mean age 49 ± 19 years) with syncope or presyncope. The mean number of episodes that patients had experienced was 14 ± 25 (range 1 to 100). After baseline supine observation for 10 minutes, patients were placed in 80 ° of head-up tilt until a positive response occurred or for a maximum of 10 minutes. Patients were then returned to the supine position for 5 minutes, followed by retilt for another 10 minutes. If the baseline tilt was negative, the study was repeated with intravenous isoproterenol, and immediate reproducibility was examined in the same manner. The 19 patients underwent a total of 31 TTTs (19 baseline and 12 follow-up on drug). The TTT was immediately reproducible in 24 of 31 tests performed (77%). Eight tests were reproducibly positive and 16 negative. The results of 7 TTTs (23%) (5 baseline and 2 follow-up on drug) were not reproducible. In 6 of these studies (86%), the positive result occurred first and the negative result second. The reproducibility of an initially negative TTT result (16 of 17; 94%) was much higher than that of an initially positive one (8 of 14; 57%). The immediate reproducibility of the TTT in adult patients with unexplained syncope is approximately 75%. In studies that are not reproducible, most (86%) are positive first and negative second. Therefore, in most patients it is not necessary to check immediate reproducibility. If a baseline TTT is negative, it may be reasonable to repeat the test during the same session in some patients, because in 1 of 9 cases (11%) a positive result will be found on the second test. The performance of acute drug testing is limited by the relatively poor immediate reproducibility of positive TTT results.
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ISSN:0002-9149
1879-1913
DOI:10.1016/0002-9149(93)90795-E