Role of Baroreflex Sensitivity in Predicting Tilt Training Response in Patients with Neurally Mediated Syncope
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Purpose: An association between baroreflex sensitivity (BRS) and the response to tilt training has not been reported in patientswith neurally mediated syncope (NMS). This study sought to investigate the role of BRS in predicting the response to tilt trainingin patients with NMS. Materials and Methods: We analyzed 57 patients who underwent tilt training at our hospital. A responder to tilt training was definedas a patient with three consecutive negative responses to the head-up tilt test (HUT) during tilt training. Results: After tilt training, 52 patients (91.2%) achieved three consecutive negative responses to the HUT. In the supine positionbefore upright posture during the first session of tilt training for responders and non-responders, the mean BRS was 18.17±10.09ms/mm Hg and 7.99±5.84 ms/mm Hg (p=0.008), respectively, and the frequency of BRS ≥8.945 ms/mm Hg was 45 (86.5%) and 1(20.0%; p=0.004), respectively. Age, male gender, frequency of syncopal events before HUT, type of NMS, phase of positive HUT, totalnumber of tilt training sessions, and mean time of tilt training did not differ between the study groups. In the multivariate analysis,BRS <8.945 ms/mm Hg in the supine position (odds ratio 23.10; 95% CI 1.20–443.59; p=0.037) was significantly and independentlyassociated with non-response to tilt training. Conclusion: The BRS value in the supine position could be a predictor for determining the response to tilt training in patientswith NMS who are being considered for inpatient tilt training.
Abstract
Purpose: An association between baroreflex sensitivity (BRS) and the response to tilt training has not been reported in patientswith neurally mediated syncope (NMS). This study sought to investigate the role of BRS in predicting the response to tilt trainingin patients with NMS. Materials and Methods: We analyzed 57 patients who underwent tilt training at our hospital. A responder to tilt training was definedas a patient with three consecutive negative responses to the head-up tilt test (HUT) during tilt training. Results: After tilt training, 52 patients (91.2%) achieved three consecutive negative responses to the HUT. In the supine positionbefore upright posture during the first session of tilt training for responders and non-responders, the mean BRS was 18.17±10.09ms/mm Hg and 7.99±5.84 ms/mm Hg (p=0.008), respectively, and the frequency of BRS ≥8.945 ms/mm Hg was 45 (86.5%) and 1(20.0%; p=0.004), respectively. Age, male gender, frequency of syncopal events before HUT, type of NMS, phase of positive HUT, totalnumber of tilt training sessions, and mean time of tilt training did not differ between the study groups. In the multivariate analysis,BRS <8.945 ms/mm Hg in the supine position (odds ratio 23.10; 95% CI 1.20–443.59; p=0.037) was significantly and independentlyassociated with non-response to tilt training. Conclusion: The BRS value in the supine position could be a predictor for determining the response to tilt training in patientswith NMS who are being considered for inpatient tilt training.
참고문헌 (21)
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