Key result
Hemodynamic complexity analysis predicts positive HUTT outcomes 120 seconds before test termination.
Why the study?
Head-up tilt testing is time-consuming and can consolidate the reflex mechanism, creating a need for parameters that could shorten test duration and prevent fainting.
Does quantitative complexity theory analysis of haemodynamic parameters improve the prediction of head-up tilt testing outcomes compared to traditional parameters in healthy volunteers?
Observational (n=81)
No
Does quantitative complexity theory analysis of haemodynamic parameters improve the prediction of head-up tilt testing outcomes compared to traditional parameters in healthy volunteers?
Quantitative complexity theory analysis of haemodynamic parameters during head-up tilt testing provides superior prediction of fainting compared to traditional heart rate and blood pressure monitoring.
Answers are grounded in this paper and cite their sources.
May aid early tilt-test positivity prediction; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Head-up tilt testing (HUTT), a well-established tool in the diagnosis of vasovagal syncope, is time-consuming, and every provoked vasovagal reaction may result in consolidating the reflex mechanism. Therefore, identification of parameters that could shorten the duration of HUTT and prevent fainting is desirable. Quantitative complexity theory (QCT) may provide holistic information on the cardiovascular reaction in HUTT. The aim of the present article was to evaluate the prognostic value of complexity in comparison with traditional haemodynamic parameters (HR and BP) in predicting the HUTT outcome. METHODS: Eighty-one healthy volunteers (74 men; mean age: 37.8 years) were included in this retrospective analysis of data collected within the project realized in Department of Cardiology and Internal Diseases, Military Institute of Medicine between January 2012 and October 2014. The subjects underwent HUTT, with beat-to-beat haemodynamic monitoring with a Niccomo™. The chosen haemodynamic parameters (including BP, HR, stroke volume, cardiac output, systemic vascular resistance) have been used in complexity analysis. RESULTS: HUTT was positive in 54 (66.7%) study participants. The values of complexity were already higher in fainting subjects than those were in nonfainting ones 300 s before HUTT termination (HUTT_end), with a significant upward trend starting 150 s before (pre)syncope. An area under the curve (AUC) over 0.700 was observed for complexity from 120 s before HUTT_end, with a sensitivity of 63% and specificity of 78% at this time point. The prognostic value of complexity was superior to that of the HR and mean arterial pressure (MAP). CONCLUSIONS: Complexity has been shown to be a sensitive marker of cardiovascular haemodynamic response to orthostatic stress and proved to be superior over HR and BP in predicting HUTT outcomes.
No takes yet. Share an insight, caveat, or question.
Krzesiński et al. (2021) conducted an observational in Healthy volunteers undergoing head-up tilt testing (n=81). Complexity analysis of haemodynamic parameters vs. Traditional haemodynamic parameters (HR and BP) was evaluated on Prediction of positive head-up tilt testing (HUTT) outcome (AUC >0.700). Complexity analysis of haemodynamic parameters predicted positive head-up tilt testing outcomes with an AUC >0.700 (63% sensitivity, 78% specificity) 120 seconds before test termination.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: