Hohnloser S H, Klingenheben T, van de Loo A, Hablawetz E, Bartsch S, Just H
Medizinische Universitätsklinik III, Kardiologie, Universität Freiburg.
Z Kardiol. 1993 Jun;82(6):352-7.
Neurally-induced syncope appears to be the underlying pathophysiologic mechanism in many patients with unexplained syncope. Diagnosis of vasovagal syncope, however, remains difficult and constitutes in many cases an exclusion diagnosis. The present study thus aimed to determine the yield of tilt-table testing in the work-up of patients with unexplained syncope and most importantly to examine the reproducibility of the results of this method. Twenty-four patients with a history of syncope and 11 healthy volunteers were examined on 2 days. In 10 patients, symptoms could be provoked during tilting, in 8 during both tests, in 2 only on one occasion. Only 1 of 11 volunteers developed presyncope during tilting which was not reproducible during the second test. These findings resulted in a sensitivity of 42% and a specificity of 91% for the protocol employed in this study. Overall reproducibility was 91% which suggests that this tilt-table protocol is suitable for evaluation of therapeutic interventions in patients with neurally-mediated syncope.
神经介导性晕厥似乎是许多不明原因晕厥患者潜在的病理生理机制。然而,血管迷走性晕厥的诊断仍然困难,在许多情况下属于排除性诊断。因此,本研究旨在确定倾斜试验在不明原因晕厥患者检查中的诊断价值,最重要的是检验该方法结果的可重复性。24例有晕厥病史的患者和11名健康志愿者在两天内接受了检查。10例患者在倾斜过程中可诱发症状,8例在两次试验中均可诱发,2例仅在一次试验中诱发。11名志愿者中只有1人在倾斜过程中出现前驱晕厥,第二次试验中未再现。这些结果使得本研究采用的方案敏感性为42%,特异性为91%。总体可重复性为91%,这表明该倾斜试验方案适用于评估神经介导性晕厥患者的治疗干预。