Teaching Department for Emergency Medical Services, Wroclaw Medical University, Bartla 5, 51-618 Wrocław, Poland.
Arch Gynecol Obstet. 2012 Aug;286(2):429-35. doi: 10.1007/s00404-012-2308-4. Epub 2012 Apr 11.
The aim of the study was to assess the distribution of positive tilt testing (TT) throughout the menstrual cycle and to determine if the phase of menstrual cycle contributes to the duration of the loss of consciousness.
TT results of 183 premenopausal women, aged 29.5 ± 9.8 years, were studied. The menstrual cycle was divided into four phases based on the first day of the last menstrual bleeding: perimenstrual (M), preovulatory (F), periovulatory (O) and postovulatory (L).
Positive TT results were equally distributed. In patients with TT in O phase, the highest percentage of NTG provocation was needed. Patients in L phase had significantly lower incidence of cardioinhibitory reaction. The longest duration of loss of consciousness was in the M phase. Multiple regression analysis revealed that the duration of loss of consciousness during positive TT was significantly associated with higher number of syncopal events, TT performed in M phase and lower heart rate at TT termination. Cardiodepressive type of neurocardiogenic reaction was more frequent during M and O phase than during L phase.
The distribution of positive TT results as well as syncope and presyncope does not differ throughout the menstrual cycle. Diagnostic TT in premenopausal women with unexplained syncope could be performed irrespective of the phase of menstrual cycle. TT has similar sensitivity throughout the menstrual cycle. During the postovulatory phase, cardioinhibitory reaction is less frequent than in M and O phases. The duration of loss of consciousness is longer during the M phase of the menstrual cycle independently of the higher syncope number and lower heart rate at TT termination.
本研究旨在评估阳性倾斜试验（TT）在整个月经周期中的分布情况，并确定月经周期的阶段是否会影响意识丧失的持续时间。
研究了 183 名年龄为 29.5±9.8 岁的绝经前女性的 TT 结果。根据末次月经出血的第一天，将月经周期分为四个阶段：月经期（M）、卵泡期（F）、排卵期（O）和黄体期（L）。
阳性 TT 结果分布均匀。在 O 期 TT 阳性的患者中，需要进行最高比例的硝酸甘油激发试验。L 期患者的心脏抑制性反应发生率显著降低。M 期患者的意识丧失持续时间最长。多变量回归分析显示，阳性 TT 期间意识丧失的持续时间与晕厥次数增加、M 期 TT 以及 TT 终止时心率降低显著相关。M 期和 O 期的心因性神经心源性反应比 L 期更频繁。
阳性 TT 结果以及晕厥和先兆晕厥的分布在整个月经周期中没有差异。对于不明原因晕厥的绝经前女性，诊断性 TT 可以在月经周期的任何阶段进行。TT 在整个月经周期中的敏感性相似。在黄体期，心脏抑制性反应比 M 期和 O 期更不常见。意识丧失的持续时间在月经周期的 M 期更长，这与较高的晕厥次数和 TT 终止时较低的心率无关。
