Key result
Patients developing syncope during HUTT exhibit ~5 mmHg lower initial DBP versus non-fainters.
Why the study?
Head-up tilt testing typically requires more than 90 minutes, and data on the relationship between diastolic blood pressure during the early minutes of tilt and the incidence of syncope were lacking.
Does diastolic blood pressure response during the first 10 minutes of head-up tilt testing correlate with a positive outcome (syncope) in patients with recurrent unexplained syncope?
Observational (n=119)
No
Does diastolic blood pressure response during the first 10 minutes of head-up tilt testing correlate with a positive outcome (syncope) in patients with recurrent unexplained syncope?
Absolute Event Rate: 75.2% vs 80%
p-value: p=<0.05
Abnormal response to orthostatic stress in vasovagal syncope is characterized by cardiac sympathetic activation and sub-optimal peripheral sympathetic response (lower DBP) during the first 10 minutes of head-up tilt testing.
May aid syncope diagnosis via tilt BP responses; hypothesis-generating and requires prospective validation before practice change.
Objectives: Head-up tilt testing has become a widely accepted tool in clinical evaluation of patients with recurrent syncope of unexplained aetiology. Several attempts have been made to evaluate vasovagal syncope (VVS) of unexplained aetiology to shorten the time duration of head-up tilt test. Scientifically validated and accepted protocol, which is used in most of the laboratories of the world, requires a time duration of more than 90 min. The study on the relationship between diastolic blood pressure (DBP) during the early few minutes of tilt and the incidence of syncope is lacking. The present study was carried out with the objective to find the correlation between positive outcome of tilt test and DBP response during the first 10 min of tilt. Materials and Methods: Retrospective analysis of the data of 119 patients (Age: Fainters [F]-26.1 ± 8.2, nonfainters [NF]-32.3 ± 10.5 years, height; F-170.9 ± 6.2, NF-169.8 ± 6.2 cm, body weight; F-65.4 ± 7.0, NF-65.8 ± 7.6 kg) was carried out for evaluation. Results: Mean heart rate was significantly higher F > NF at four (92.3 ± 19.0 vs. 84.3** ± 13.6), six (91.9 ± 18.6 vs. 85.1* ± 13.7), eight (93.8 ± 19.5 vs. 85.8** ± 13.4) and ten (95.4 ± 18.9 vs. 86.1** ± 13.9) minutes of tilt, while systolic and DBP were lower F<NF at zero (115.4 ± 14.2 vs. 122.6* ± 14.7) and six (120.8 ± 13.0 vs. 126.1* ± 13.2) and zero (75.2 ± 10.3 vs. 80.0* ± 11.6) and two (76.3 ± 12.8 vs. 82.0* ± 11.0) minutes, respectively (* p < 0.05, ** p < 0.01). The pathophysiology of VVS remains elusive. Conclusion: The findings of the present study elucidate that abnormal response to orthostatic stress in VVS is a combination of cardiac sympathetic activation along with sub-optimal peripheral sympathetic response, manifesting as syncope.
No takes yet. Share an insight, caveat, or question.
Sinha et al. (2026) conducted an observational in Recurrent syncope of unexplained aetiology (n=119). Positive response to head-up tilt testing (Syncope) vs. Negative response to head-up tilt testing (Non-fainters) was evaluated on Diastolic blood pressure at 0 minutes of head-up tilt (p=<0.05). Patients who developed syncope during head-up tilt testing exhibited significantly lower diastolic blood pressure at 0 and 2 minutes of tilt compared to non-fainters (75.2 vs 80.0 mmHg at 0 min, p<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: