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Age and gender differences in basal and isoprenaline protocols for head-up tilt table testing
G Barón-Esquivias1, A Pedrote, A Cayuela
1Cardiology Department, Hospital Universitario Virgen del Rocío, Seville, Spain. gbaron@jet.es
Summary
Head-up tilt table testing (HUT) is a key diagnostic tool for syncope. Basal HUT is effective in younger patients, but its positive rate declines with age, suggesting a need for alternative protocols in the elderly.
Area of Science:
- Cardiology
- Neurology
Background:
- Syncope is a common condition, particularly in older individuals.
- Neurally mediated syncope is a frequent cause in both young and elderly populations.
- Head-up tilt table testing (HUT) is the preferred diagnostic method for neurally mediated syncope.
Purpose of the Study:
- To analyze age and gender influences on HUT results for syncope patients.
- To compare outcomes between basal and isoprenaline HUT protocols.
Main Methods:
- 1,219 syncope patients underwent HUT between 1990 and 2000.
- 1,061 patients had basal HUT (Group A), and 158 had isoprenaline HUT (Group B).
- No complications were reported for either protocol.
Main Results:
- Head-up tilt table testing was positive in 24.4% of Group A and 53.7% in Group B patients.
- The positive rate of basal HUT significantly decreased with age in both genders.
- No significant age-related decline in positive test rates was observed with the isoprenaline protocol.
Conclusions:
- Basal HUT demonstrates a high diagnostic yield in younger syncope patients.
- The declining positive rate of basal HUT with increasing age highlights the need for alternative testing strategies in the elderly.
- The isoprenaline protocol may offer similar diagnostic accuracy across different age groups.