Abstract：Objective To summarize the risk factors of headup tilt test(HUTT) in patients with vasovagal syncope(VSS), and to study their 24hour heart rate variability(HRV) during asymptomatic period. Methods A total of 173 patients suspected with VVS received HUTT, including basic HUTT(BHUTT) and sublingual nitroglycerin test(SNHUTT). They were divided into HUTT positive group(82 cases) and HUTT negative group(91 cases) according to test results. The clinical characterizations and HRV of the two groups were analyzed, and multivariate Logistic regression analysis was made. Results (ⅰ) HUTT hemodynamic types: in HUTT positive group, 8 patients were positive in BHUTT(6 cases with vasodepressor syncope and 2 with mixed response) while 74 were positive in SNHUTT(55 cases with vasodepressor syncope， 3 with cardioinhibitory syncope and 16 with mixed response). (ⅱ) Clinical manifestations: at the attack of syncope in HUTT positive group, the common accompanying symptoms were orderly chest tightness or pains(51.22%), dizziness or headache(50.00%), palpitation(47.56%), sweating(39.02%) and fatigue(37.80%). (ⅲ) Single factor analysis demonstrated that female（χ2=4.242，P=0.039）,≥60 years old（χ2=5.449，P=0.020）, clinical manifestations of sicchasia or emesia(χ2=4.759, P=0.029) and symptoms of abdominal pain(χ2=5.410, P=0.020) were risk factors for positive HUTT. (ⅳ) Logistic regression analysis indicated that ≥60 years old(OR=0.520, P=0.041) was an independent risk factor for positive HUTT. (ⅴ) Comparison of 24hour HRV: the timedomain index of rMSSD in HUTT positive group was statistically significantly higher than that in HUTT negative group[(37.41±24.19) ms vs. (30.76 13.16) ms, P=0.024]. Conclusion Sex, age, clinical features of sicchasia or emesia and abdominal pain are related factors for positive HUTT. The autonomic verve function in VVS patients during asymptomatic period is abnormal.
郭冰丽, 张树龙, 洪丽. 直立倾斜试验阳性结果影响因素及患者的临床特征分析[J]. 实用心电学杂志, 2017, 26(2): 111-115.
GUO Bing-Li, ZHANG Shu-Long, HONG Li. Analysis on influencing factors for positive result of head-up tilt test and vasovagal syncope patients’ clinical features〖. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2017, 26(2): 111-115.
[1] Johansen JB，Nielsen JC.Vasovagal syncope:poorly understood,but well handled[J].Europace，2012，14(9):1228-1229.[2] Corcoran SJ，Lambert EA.Vasovagal syncopethe electricity,the pump or the input pressure[J].J Physiol，2012，590(8):1775-1776.[3] Emkanjoo Z，Alizadeh A，Alasti M，et a1.Correlation between results of headup tilt test and clinical features in patients with syncope or presyncope[J].J Electrocardiol，2007，40(2):200-202.[4] Kollar B，Mikes P，Siarnik P，et a1.Vasovagal(neurocardiogenic) syncope in the clinical practice[J].Neuro Endocrinol Lett，2012，33(1):60-66.[5] Petix NR，Del Rosso A，Furlan R，et a1.Nitratepotentiated headup tilt testing(HUT) has a low diagnostic yield in patients with likely vasovagal syncope[J].Pacing Clin Electrophysiol，2014，37(2):164-172.[6] Forleo C，Guida P，Iacoviello M，et a1.Headup tilt testing for diagnosing vasovagal syncope:a metaanalysis[J].Int J Cardiol，2013，169(4):e49-e50.[7] Goel R，Caracciolo G，Wilansky S，et a1.Effect of headup tilttable testing on left ventricular longitudinal strain in patients with neurocardiogenic syncope[J].Am J Cardiol，2013，112(8):1252-1257.[8] Lee SH，Park SJ，Byeon K，et a1.Prevalence and clinical factors of anxiety and depression in neurally mediated and unexplained syncope[J].Yonsei Med J，2013，54(3):583-589.[9] Alboni P.The different clinical presentations of vasovagal syncope[J].Heart，2015，101(9):674-678.[10] Shim SH，Park SY，Moon SN，et a1.Baseline heart rate variability in children and adolescents with vasovagal syncope[J].Korean J Pediatr，2014，57(4):193-198.[11] Vaddadi G，Corcoran SJ，Esler M.Management strategies for recurrent vasovagal syncope[J].Intern Med J，2010，40(8)：554-560.
2017, Vol. 26 
