Female patients with vasovagal syncope demonstrated significantly higher pulse pressure compared to healthy subjects and lacked the expected changes in heart rate asymmetry during orthostatic stress.
Case-Control (n=35)
No
Do heart rate and blood pressure asymmetry parameters differ between females with vasovagal syncope and healthy controls during a tilt test?
While heart rate and blood pressure asymmetry parameters differ between vasovagal and healthy females during orthostatic stress, their diagnostic utility for vasovagal syncope remains limited.
Absolute Event Rate: 41.47% vs 35.87%
p-value: p=0.019
Introduction: Heart Rate Asymmetry (HRA) describes a phenomenon of differences between accelerations and decelerations in human heart rate. Methods used for HRA assessment can be further implemented in the evaluation of asymmetry in blood pressure variations (Blood Pressure Asymmetry—BPA). Methods: We have analyzed retrospectively the series of heartbeat intervals extracted from ECG and beat-to-beat blood pressure signals from 16 vasovagal patients (age: 32.1 ± 13.3; BMI: 21.6 ± 3.8; all female) and 19 healthy subjects (age: 34.6 ± 7.6; BMI: 22.1 ± 3.4; all female) who have undergone tilt test (70°). Asymmetry was evaluated with Poincaré plot-based methods for 5 min recordings from supine and tilt stages of the test. The analyzed biosignals were heart rate (RR), diastolic (dBP) and systolic Blood Pressure (sBP) and Pulse Pressure (PP). In the paper we explored the differences between healthy and vasovagal women. Results: The changes of HRA indicators between supine and tilt were observed only in the control group (Porta Index p = 0.026 and Guzik Index p = 0.005). No significant differences in beat-to-beat variability (i.e. spread of points across the line of identity in Poincaré plot—SD1) of dBP was noted between supine and tilt in the vasovagal group ( p = 0.433 in comparison to p = 0.014 in healthy females). Moreover, in vasovagal patients the PP was significantly different (supine: 41.47; tilt: 39.27 mmHg) comparing to healthy subjects (supine: 35.87; tilt: 33.50 mmHg) in supine ( p = 0.019) and in tilt ( p = 0.014). Discussion: Analysis of HRA and BPA represents a promising method for the evaluation of cardiovascular response to orthostatic stressors, however currently it is difficult to determine a subject’s underlying health condition based only on these parameters.
Pawłowski et al. (Mon,) conducted a case-control in Vasovagal syncope (n=35). Vasovagal syncope vs. Healthy controls was evaluated on Pulse pressure (PP) in the supine position (p=0.019). Female patients with vasovagal syncope demonstrated significantly higher pulse pressure compared to healthy subjects and lacked the expected changes in heart rate asymmetry during orthostatic stress.
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