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. 2019 Mar 7:10:184.
doi: 10.3389/fphys.2019.00184. eCollection 2019.

Hemodynamic Response to the Head-Up Tilt Test in Patients With Syncope as a Predictor of the Test Outcome: A Meta-Analysis Approach

Katarzyna Buszko  1 , Sławomir Kujawski  2 , Julia L Newton  3 , Paweł Zalewski  2
Affiliations

Hemodynamic Response to the Head-Up Tilt Test in Patients With Syncope as a Predictor of the Test Outcome: A Meta-Analysis Approach

Katarzyna Buszko et al. Front Physiol. .

Abstract

Aim: The paper presents a meta-analysis of studies comparing hemodynamic parameters: heart rate (HR), systolic blood pressure (sBP), diastolic blood pressure (dBP), and stroke volume (SV) measured during head-up tilt table test (HUTT) in patients with positive and negative HUT test outcome. Methods: Pubmed and Clinical Key databases were searched for English-only articles presenting results of biosignals measurements during tilt test in patients suffering from syncope. From 3,289 articles 13 articles published between 1997 and 2015 investigating 892 patients (467 with positive HUTT outcome and 401 with negative one) were selected. Results: There were not statistically significant differences observed between the parameters measured in supine position in patients with positive and negative test outcome [HR (p = 0.86), sBP (p = 0.32), dBP (p = 0.21), SV (p = 0.71)]. In tilt position the parameters HR and SV were significantly different when compared between the two groups of patients [HR (p = 0.02), sBP (p = 0.10), dBP (p = 0.59), SV (p = 0.0004)]. Conclusions: Changes in HR and SV parameters in response to tilt test turned out to be statistically significant. In supine position the differences between patients with positive and negative test outcome were not significant, hence tilt test can be considered as necessary in the diagnosis of vasovagal syndrome.

Keywords: blood pressure; head up tilt test; heart rate; meta-analysis; stroke volume; vasovagal syncope.

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Figures

Figure 1
Figure 1
Flow diagram of the process of selection of study materials.
Figure 2
Figure 2
Forest plots estimating the parameters HR, sBP, dBP and SV for the patients with positive (HUTT(+)) and negative (HUTT(–)) tilt test outcome: (A) supine position, (B) tilt.
Figure 3
Figure 3
Funnel plots for the estimated parameters HR, sBP, dBP and SV for the patients with positive (HUTT(+)) and negative (HUTT(–)) tilt test outcome: (A) supine position, (B) tilt.
See this image and copyright information in PMC

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