Bilagi Umesh R, Shenthar Jayaprakash, Cholenahally Manjunath Nanjappa
Department of Cardiology, Karnataka Institute of Medical Sciences, Vidyanagar, Hubli 580020, Karnataka, India.
Electrophysiology Unit, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Cardiology, B.G. Road, Bangalore 560069, Karnataka, India.
Indian Heart J. 2017 Jan-Feb;69(1):48-51. doi: 10.1016/j.ihj.2016.06.007. Epub 2016 Jun 20.
HUTT test is used in evaluation of syncope. Isoprenaline and isosorbide dinitrate are used to increase the sensitivity of the test. These drugs act by different mechanisms. We aimed to compare the results of isoprenaline with isosorbide dinitrate.
We studied 198 subjects referred for HUTT to our institute; those above the age of 35 years were not included in our study, because isoprenaline was not used commonly above this age; thus, only 90 subjects were analyzed. We found that isosorbide dinitrate resulted in more HUTT-positive results than isoprenaline by absolute risk difference of 26%; relative risk for positive isoprenaline was 60%, confidence interval 0.38-0.93, and P value of 0.03. There was no difference in frequency of types of responses, i.e. Type 1, Type 2, and Type 3 between passive testing, isosorbide dinitrate, and isoprenaline, confidence interval 1.53-2.02, and P value 0.71. Time to get positive response was highest for passive testing followed by ISO and ISDN; the mean was 16.85±7.00min, 9.85±5.84min, and 7.00±3.35min, respectively. Statistically, ISDN versus ISO time to get positive response was not significant; P value was 0.074 and 95% confidence interval was -0.28 to 5.98.
Isosorbide dinitrate yields more positive HUTT than isoprenaline. The frequencies of type of responses are not different between passive testing, isosorbide dinitrate, and isoprenaline. There is no difference in time taken for positive response between isosorbide dinitrate and isoprenaline. In comparison to isosorbide dinitrate and isoprenaline, passive testing showed longest time for positive response.
直立倾斜试验（HUTT）用于评估晕厥。异丙肾上腺素和硝酸异山梨酯用于提高该试验的敏感性。这些药物通过不同机制起作用。我们旨在比较异丙肾上腺素和硝酸异山梨酯的试验结果。
我们研究了198名转诊至我院进行直立倾斜试验的受试者；35岁以上的受试者未纳入我们的研究，因为该年龄以上不常用异丙肾上腺素；因此，仅对90名受试者进行了分析。我们发现，硝酸异山梨酯导致的直立倾斜试验阳性结果比异丙肾上腺素更多，绝对风险差异为26%；异丙肾上腺素阳性的相对风险为60%，置信区间为0.38 - 0.93，P值为0.03。被动试验、硝酸异山梨酯和异丙肾上腺素之间的反应类型（即1型、2型和3型）频率无差异，置信区间为1.53 - 2.02，P值为0.71。被动试验获得阳性反应的时间最长，其次是异丙肾上腺素和硝酸异山梨酯；平均值分别为16.85±7.00分钟、9.85±5.84分钟和7.00±3.35分钟。统计学上，硝酸异山梨酯与异丙肾上腺素获得阳性反应的时间无显著差异；P值为0.074，95%置信区间为 -0.28至5.98。
硝酸异山梨酯导致的直立倾斜试验阳性结果比异丙肾上腺素更多。被动试验、硝酸异山梨酯和异丙肾上腺素之间的反应类型频率无差异。硝酸异山梨酯和异丙肾上腺素获得阳性反应的时间无差异。与硝酸异山梨酯和异丙肾上腺素相比，被动试验显示获得阳性反应的时间最长。
