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| Diagnostic value of transcranial Doppler combined with head-up tilt test in orthostatic cerebral hypoperfusion syndrome patients |
| WANG Jiayu, WU Yueyang, ZHANG Jia, LIU Jiexin |
| (1. Neurosurgery and Cardiology Center, 2. Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China) |
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Abstract Objective To investigate the diagnostic value of transcranial Doppler (TCD) combined with head-up tilt test (HUTT) in patients with orthostatic cerebral hypoperfusion syndrome (OCHOs). Methods We selected the patients going to hospital due to syncope or suspected orthostatic intolerance, and their etiology was considered as OCHOs. Cerebral blood flow parameters and hemodynamic parameters of patients were collected separately by TCD and HUTT, and healthy control group was set up. TCD cerebral blood flow parameters and HUTT hemodynamic parameters were compared between the OCHOs patients and the control group. Results A total of 56 OCHOs patients (case group) and 21 healthy adults in the control group are enrolled. In terms of TCD cerebral blood flow parameters, compared with the supine position, the absolute values of the decrease of systolic, end-diastolic and mean cerebral blood flow velocity in the case group are significantly higher than those in the control group during the tilt upright position; the absolute values of the increase of pulse index and circulation resistance index are also significantly higher than those in the control group (P<0.01). There is no significant difference in HUTT hemodynamic parameters between the two groups (P>0.05). The receiver operator characteristic curve is drawn. Compared with the supine position, systolic, end-diastolic and mean cerebral blood flow velocity in the case group decrease by 14.5, 9.5 and 13.5 cm/s, respectively during the tilt upright position. Their sensitivity is separately 94.6%, 87.5% and 91.1% while the specificity is separately 95.2%, 85.7% and 95.2% in diagnosing OCHOs (P＜0.01). Conclusion TCD combined with HUTT plays an important role in diagnosing OCHOs.
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