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Published on: March 21, 2013
Relationship between syncopal symptoms and head-up tilt test modes
Shuo Wang1,2, Yali Peng3, Yuwen Wang2
1Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.
Insights
In pediatric vasovagal syncope, previous syncopal episodes significantly increase the likelihood of a positive basic head-up tilt test (BHUT) compared to the sublingual nitroglycerine head-up tilt test (SNHUT). This finding aids in selecting the appropriate diagnostic method.
Area of Science:
- Pediatrics
- Cardiology
- Neurology
Background:
- Vasovagal syncope is a common cause of syncope in children.
- The head-up tilt test (HUTT) is a key diagnostic tool for pediatric vasovagal syncope.
- Different HUTT protocols exist, including basic HUTT (BHUT) and sublingual nitroglycerine HUTT (SNHUT).
Purpose of the Study:
- To investigate the relationship between syncopal symptoms and HUTT modes in pediatric vasovagal syncope.
- To compare the diagnostic yield of BHUT versus SNHUT in children with vasovagal syncope.
Main Methods:
- Retrospective analysis of clinical data from 2513 children (aged 3-18 years) diagnosed with vasovagal syncope between 2001 and 2021.
- Patients were categorized into BHUT (596) and SNHUT (1917) groups based on their positive HUTT mode.
- Statistical analysis included univariate and multivariate analyses to identify risk factors for BHUT positivity.
Main Results:
- Baseline characteristics such as age, heart rate, and blood pressure were higher in the BHUT group.
- Univariate analysis identified age, height, weight, heart rate, blood pressure, and syncope as potential risk factors for BHUT positivity.
- Multivariate analysis confirmed syncope as an independent risk factor for BHUT positivity, increasing the likelihood by 121% compared to pre-syncope.
Conclusions:
- The probability of a positive BHUT is significantly higher than SNHUT in pediatric patients with a history of syncopal episodes.
- This suggests that BHUT may be more sensitive in diagnosing vasovagal syncope in children who have previously experienced syncope.
Objective:
Head-up tilt test (HUTT) is an important tool in the diagnosis of pediatric vasovagal syncope. This research will explore the relationship between syncopal symptoms and HUTT modes in pediatric vasovagal syncope.
Methods:
A retrospective analysis was performed on the clinical data of 2513 children aged 3-18 years, who were diagnosed with vasovagal syncope, from Jan. 2001 to Dec. 2021 due to unexplained syncope or pre-syncope. The average age was 11.76 ± 2.83 years, including 1124 males and 1389 females. The patients were divided into the basic head-up tilt test (BHUT) group (596 patients) and the sublingual nitroglycerine head-up tilt test (SNHUT) group (1917 patients) according to the mode of positive HUTT at the time of confirmed pediatric vasovagal syncope.
Results:
(1) Baseline characteristics: Age, height, weight, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and composition ratio of syncope at baseline status were higher in the BHUT group than in the SNHUT group (all P < 0.05). (2) Univariate analysis: Age, height, weight, HR, SBP, DBP, and syncope were potential risk factors for BHUT positive (all P < 0.05). (3) Multivariate analysis: syncope was an independent risk factor for BHUT positive, with a probability increase of 121% compared to pre-syncope (P<0.001).
Conclusion:
The probability of BHUT positivity was significantly higher than SNHUT in pediatric vasovagal syncope with previous syncopal episodes.
