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Underlying hemodynamic differences are associated with responses to tilt testing

Fedorowski, Artur LU orcid ; Rivasi, Giulia ; Torabi, Parisa LU orcid ; Johansson, Madeleine LU orcid ; Rafanelli, Martina ; Marozzi, Irene ; Ceccofiglio, Alice ; Casini, Niccolò ; Hamrefors, Viktor LU orcid and Ungar, Andrea , et al. (2021) In Scientific Reports 11. p.1-6
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... (More)
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. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
11
article number
17894
pages
1 - 6
publisher
Nature Publishing Group
external identifiers
  • pmid:34504263
  • scopus:85114673701
ISSN
2045-2322
DOI
10.1038/s41598-021-97503-0
language
English
LU publication?
yes
id
9e6c969b-ca93-4447-81c5-41bafa69930e
date added to LUP
2021-09-11 15:21:26
date last changed
2023-12-07 16:57:18
@article{9e6c969b-ca93-4447-81c5-41bafa69930e,
  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 &lt; 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p &lt; 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p &lt; 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 &lt; 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17–1.50, p &lt; 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38–1.81, p &lt; 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.}},
  author       = {{Fedorowski, Artur and Rivasi, Giulia and Torabi, Parisa and Johansson, Madeleine and Rafanelli, Martina and Marozzi, Irene and Ceccofiglio, Alice and Casini, Niccolò and Hamrefors, Viktor and Ungar, Andrea and Olshansky, Brian and Sutton, Richard and Brignole, Michele and Parati, Gianfranco}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  pages        = {{1--6}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Underlying hemodynamic differences are associated with responses to tilt testing}},
  url          = {{http://dx.doi.org/10.1038/s41598-021-97503-0}},
  doi          = {{10.1038/s41598-021-97503-0}},
  volume       = {{11}},
  year         = {{2021}},
}