Asensio Lafuente Enrique, Colín Ramírez Eloisa, Castillo Martínez Lilia, Oseguera Moguel Jorge, Narváez David René, Dorantes García Joel, Galindo Uribe Jaime, Orea Tejeda Arturo
Clínica de Arritmias y Marcapasos, Departamento de Cardiología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga Núm. 15, Col. Sección XVI, Tlalpan México 14000, DF, México.
Arch Cardiol Mex. 2006 Jan-Mar;76(1):59-62.
Neurocardiogenic syncope (NCS) is diagnosed by means of a head-up tilt table tests (HUTT). This is a prolonged test although early outcome predictors are known.
We conducted a study among patients engaged in a syncope study protocol. We performed HUTT in all of them and compared the basal arterial pressure with the arterial pressure at the end of a the 70 degrees tilting.
We performed 185 HUTT studies. Systolic blood pressure (BP) raised 0.9% among patients with a negative test, whereas patients with a positive HUTT showed a 2.3% decrease (p = 0.2) in the same measurement. Diastolic BP increased 34% among negative HUTT patients and 14.9% among patients with positive test (p = 0.02). We calculated a relative risk of 1.45 for positive test when the combination of systolic BD decrease and dyastolic increase was present, according to the percentage of change (IC95%: 1.1 to 7.8).
The combination of systolic BP reduction and diastolic BP elevation at the end of the 70 degrees tilting is associated with an increased risk of having a positive HUTT. These changes might be related to differential sympathetic stimulation.
通过直立倾斜试验(HUTT)诊断神经心源性晕厥(NCS)。尽管已知早期结果预测指标,但这是一项耗时较长的试验。
我们对参与晕厥研究方案的患者进行了一项研究。我们对所有患者进行了HUTT,并将基础动脉压与70度倾斜结束时的动脉压进行了比较。
我们进行了185项HUTT研究。试验结果为阴性的患者收缩压升高了0.9%,而试验结果为阳性的患者在相同测量中收缩压下降了2.3%(p = 0.2)。试验结果为阴性的患者舒张压升高了34%,试验结果为阳性的患者舒张压升高了14.9%(p = 0.02)。根据变化百分比(95%置信区间:1.1至7.8),当出现收缩压下降和舒张压升高的组合时,阳性试验的相对风险计算为1.45。
70度倾斜结束时收缩压降低和舒张压升高的组合与HUTT阳性风险增加相关。这些变化可能与不同的交感神经刺激有关。