The Role of the Baroreflex in Tilt Table Testing: Outcome and Type of Response

JACC. Clinical Electrophysiology
Ashish ChaddhaMohamed H Hamdan

Abstract

The purpose of this study was to better understand the role of the baroreflex in tilt-induced vasovagal syncope (VVS). The role of the baroreflex in tilt-induced VVS remains controversial. The authors hypothesized that: 1) patients with positive tilt table test (TTT) results have greater baroreflex gain (BRG) compared with patients with negative TTT results; and 2) patients with tilt-induced asystole have greater BRG compared with patients without asystole. Using the sequence method, BRG measurements were obtained in 438 consecutive patients undergoing TTT. Two hundred sixty-eight patients (61%) had positive TTT results (mean age 50 ± 21 years; 34% men), and 170 patients (39%) had negative TTT results (mean age 48 ± 21 years; 35% men). Mean BRG was significantly higher in patients with positive TTT results compared with those with negative TTT results (12.9 ± 6.0 ms/mm Hg vs. 11.5 ± 6.0 ms/mm Hg; p = 0.01). Among the 268 patients with positive TTT results, 23 (9%) had more than 3 s of asystole (mean age 37 ± 17; 30% men), and 245 patients had a mixed vasodepressor or cardioinhibitory response without asystole (mean age 51 ± 17 years; 34% men). Mean BRG was greater in patients with tilt-induced asystole (>3 s) compared with pati...Continue Reading

Citations

Apr 2, 2020·Frontiers in Cardiovascular Medicine·J Gert van DijkRoland D Thijs
Jul 3, 2017·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Michele BrignoleAlessio Gargaro
Feb 10, 2021·Journal of Hypertension·Michele BrignoleArtur Fedorowski
Mar 31, 2019·Journal of the American Medical Directors Association·Alice CeccofiglioAndrea Ungar

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