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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2021-09-01
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doaj-fa061eb26f0342b8b1dedd70656c24f52021-09-12T11:24:27ZengNature Publishing GroupScientific Reports2045-23222021-09-011111610.1038/s41598-021-97503-0Underlying hemodynamic differences are associated with responses to tilt testingArtur Fedorowski0Giulia Rivasi1Parisa Torabi2Madeleine Johansson3Martina Rafanelli4Irene Marozzi5Alice Ceccofiglio6Niccolò Casini7Viktor Hamrefors8Andrea Ungar9Brian Olshansky10Richard Sutton11Michele Brignole12Gianfranco Parati13Department of Clinical Sciences, Lund UniversitySyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceDepartment of Clinical Sciences, Lund UniversityDepartment of Clinical Sciences, Lund UniversitySyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceDepartment of Clinical Sciences, Lund UniversitySyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of FlorenceDivision of Cardiology, Department of Internal Medicine, University of Iowa HospitalsDepartment of Cardiology, Skåne University HospitalFaint & Fall Programme, IRCCS Istituto Auxologico Italiano, Ospedale San LucaFaint & Fall Programme, IRCCS Istituto Auxologico Italiano, Ospedale San LucaAbstract 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.https://doi.org/10.1038/s41598-021-97503-0 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
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 |
spellingShingle |
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 Scientific Reports |
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 Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-09-01 |
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. |
url |
https://doi.org/10.1038/s41598-021-97503-0 |
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