Cardiovascular medicine
The normal response to prolonged passive head up tilt testing
M E V Petersen, T R Williams, C Gordon, R Chamberlain-Webber, R Sutton
Department of
Cardiology, Chelsea and Westminster Hospital, 369 Fulham Road, London
SW10 9NH, UK
Correspondence to: Dr Petersen drmev.peterson{at}virgin.net
Accepted 17 July 2000
OBJECTIVE
To define the responses to
head up tilt in a large group of normal adult subjects using the most
widely employed protocol for tilt testing.
METHODS127 normal subjects aged
19-88 years (mean (SD), 49 (20) years) without a previous history of
syncope underwent tilt testing at 60° for 45 minutes or until syncope
intervened. Blood pressure monitoring was performed with digital
photoplethysmography, providing continuous, non-invasive, beat to
beat heart rate and pressure measurements.
RESULTS13% of subjects developed
vasovagal syncope after a mean (SD) tilt time of 31.7 (12.4) minutes
(range 8.5-44.9 minutes). Severe cardioinhibition during syncope was
observed less often than is reported in patients investigated for
syncope. There were no differences in the age or sex distributions of
subjects with positive or negative outcomes, or in the proportions with
cardioinhibitory and vasodepressor vasovagal syncope compared with
previously reported patient populations. Subjects with negative
outcomes showed age related differences in heart rate and blood
pressure behaviour throughout tilt.
CONCLUSIONSFalse positive results
with tilting appear to be common. This has important implications for
the use of diagnostic tilt testing. The magnitude of the heart rate and
blood pressure changes observed during negative tilts largely
invalidates previously suggested criteria for abnormal non-syncopal outcomes.
Keywords: syncope; head up tilt; postural hypotension
© 2000 by Heart
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Fuca, G., Dinelli, M., Gianfranchi, L., Bressan, S., Lamborghini, C., Alboni, P.
(2008). Do subjects with vasovagal syncope have subtle haemodynamic alterations during orthostatic stress?. Europace
10: 751-759
[Abstract] [Full Text] -
Kurbaan, A. S., Bowker, T. J., Wijesekera, N., Franzen, A.-C., Heaven, D., Itty, S., Sutton, R.
(2003). Age and hemodynamic responses to tilt testing in those with syncope of unknown origin. J Am Coll Cardiol
41: 1004-1007
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
