Guo Yongzhe, Lin Tao, Lin Nanyu, Lin Huizhong
Department of Cardiology, Fujian Heart Medical Center, Fujian Institute of Coronary Heart Disease, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Epidemiology, School of Public Health, Fujian Medical University, Fuzhou, China.
Front Cardiovasc Med. 2024 Sep 3;11:1333684. doi: 10.3389/fcvm.2024.1333684. eCollection 2024.
Vasovagal syncope (VVS) is a prevalent medical condition with a lack of efficient methods for its detection.
This study aimed to explore an objective clinical indicator in diagnosing VVS.
The retrospective analysis involved clinical data of 243 syncope patients from 1 June 2020 to 31 July 2023. Among them, 108 patients had a negative result in the tilt test (TTT), while the remaining 135 patients had a positive result in the TTT. Relevant statistical methods were utilized to examine the correlation between VVS and different indicators of heart rate variability.
After screening, 354 patients being considered for VVS were evaluated, resulting in a final sample size of 243. Sex, age, deceleration capacity (DC), and standard deviation of all normal-to-normal intervals (SDNNs) were the variables that showed statistical significance between the TTT(-) group and the TTT(+) group. Independent risk factors identified by multivariate logistic regression were DC [odds ratio (OR) 1.710, 95% confidence interval (CI) 1.388-2.106, < 0.001] and SDNN (OR 1.033, 95% CI 1.018-1.049, < 0.001). Comparing the groups, receiver operating characteristic analysis revealed a notable distinction in both DC and SDNN [the respective areas under the curve were 0.789 (95% CI 0.730-0.848) and 0.702 (95% CI 0.637-0.767); the cutoff values were 7.15 and 131.42; < 0.001, respectively].
In summary, DC can function as an impartial and easily accessible clinical marker for differentiating VVS. A value exceeding 7.15 ms might suggest a higher likelihood of syncope.
血管迷走性晕厥(VVS)是一种常见的医学病症,缺乏有效的检测方法。
本研究旨在探索一种诊断VVS的客观临床指标。
回顾性分析了2020年6月1日至2023年7月31日期间243例晕厥患者的临床资料。其中,108例患者倾斜试验(TTT)结果为阴性,其余135例患者TTT结果为阳性。采用相关统计方法检验VVS与心率变异性不同指标之间的相关性。
经过筛选,对354例疑似VVS患者进行了评估,最终样本量为243例。性别、年龄、减速能力(DC)和全部正常到正常间期的标准差(SDNNs)是在TTT(-)组和TTT(+)组之间显示出统计学意义的变量。多因素逻辑回归确定的独立危险因素为DC[比值比(OR)1.710,95%置信区间(CI)1.388-2.106,P<0.001]和SDNN(OR 1.033,95%CI 1.018-1.049,P<0.001)。比较两组,受试者工作特征分析显示DC和SDNN均有显著差异[曲线下面积分别为0.789(95%CI 0.73-0.848)和0.702(95%CI 0.637-0.767);截断值分别为7.15和131.42;P均<0.001]。
总之,DC可作为鉴别VVS的客观且易于获取的临床标志物。超过7.15毫秒的值可能提示晕厥可能性较高。