Key result
Heart rate variability and heart rate turbulence parameters did not differ significantly between patients with positive (n=60, 37.2%) and negative head-up tilt test results.
Why the study?
The autonomic nervous system plays an important role in vasovagal syncope, but studies assessing the effect of basal autonomic tone have found confusing results.
Do basal autonomic functions assessed by HRV and HRT differ between patients with positive versus negative head-up tilt tests for unexplained syncope?
Observational (n=161)
Do basal autonomic functions assessed by HRV and HRT differ between patients with positive versus negative head-up tilt tests for unexplained syncope?
Basal autonomic functions assessed by HRV and HRT do not differ between patients with and without vasovagal syncope, suggesting basal autonomic tone may not be the primary driver of its pathogenesis.
No differences in basal HRV/HRT by HUTT status; leaves open whether autonomic tone drives vasovagal syncope pathogenesis.
Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope.Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24 hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured.Results The age of the patients varied from 16 to 75 yrs (mean: 44.8±18.5 yrs). HUTT results of 60 (37.2 %) patients were evaluated as positive. There were no significant differences in the basal demographic, clinical, or laboratory findings of the tilt-positive and tilt-negative patient groups. Likewise, there were no significant differences between the time domain HRV parameters and HRT parameters of both groups.Conclusion HRV and HRT parameters reflecting basal autonomic function were not different between HUTT positive and HUTT negative patient groups. These findings suggest that basal autonomic functions have no effect on vasovagal syncope pathogenesis.
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Akıncı et al. (2021) conducted an observational in vasovagal syncope (n=161). Positive head-up tilt test (HUTT) vs. Negative head-up tilt test (HUTT) was evaluated on Time domain heart rate variability (HRV) and heart rate turbulence (HRT) parameters. Heart rate variability and heart rate turbulence parameters did not differ significantly between patients with positive (n=60, 37.2%) and negative head-up tilt test results.
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