Predictive Value of Blood Pressure,Heart Rate,and Blood Pressure/Heart Rate Ratio in a Chinese Subpopulation with Vasovagal Syncope  

作　　者：Zhuzhi Wen Jingying Hou Zun Mai Huifen Huang Yangxin Chen Dengfeng Geng Jingfeng Wang 

机构地区：[1]Department of Cardiology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou,China [2]Guandong Province Key Laboratory of Arrhythmia and Electrophysiology,Guangzhou,China [3]Emergency Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,China [4]Breast Tumor Center,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,China

出　　处：《Cardiovascular Innovations and Applications》2021年第1期193-205,共13页心血管创新与应用（英文）

基　　金：the Guangdong Natural Science Foundation Project(2018A030313531);the Yat-Sen Scholarship for Young Scientists.

摘　　要：Objective:The head-up tilt test(HUTT)is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope(VVS).The present study aims to verify the hypothesis that ambulatory blood pressure(BP)monitoring(ABPM)and the simplistic tilt test may be potential alternatives to the HUTT.Methods:The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS.BP),heart rate(HR),and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence,pattern,and stage of syncope during the HUTT.Results:Mixed response was the commonest pattern,and syncope occurred frequently with infusion of isoproterenol at a rate of 3μg/min.During the simplistic tilt test,the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group,while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group.The higher the BP/HR ratio in the tilted position,the higher the isoproterenol dosage needed to induce a positive response.During ABPM,BP/HR ratios were signifi cantly higher in the cardioinhibitory group than in the vasodepressor group.The higher the ABPM-derived BP,the higher the dosage of isoproterenol needed to induce syncope.There were signifi cant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group,while signifi cant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group.The mixed pattern shared correlative features of the other two patterns.Conclusion:ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.

关 键 词：Vasovagal syncope head-up tilt test simplistic tilt test ambulatory blood pressure monitoring blood pressure/heart rate ratio 

分 类 号：R54[医药卫生—心血管疾病]