Head up tilt table test: a profile and association of hypertension with a positive test
Location
Auditorium Pond Side
Start Date
26-2-2014 10:30 AM
Abstract
Background: Head up tilt test (HUTT) is an arguable gold standard. No data available from Pakistan. The test relies on vasodilatation. Hypertension would intuitively make a case for resisting positivity.
Aim: To look at the profile of HUTT and also see the association between hypertension with the time taken to positive test.
Materials and Methods: A retrospective study done at the Aga Khan University hospital. Details of all HUTTs between January 2002 and 2007 were recorded. HUTT protocols were 30 and 45 minutes plain tilt at 60 degrees and 15 minutes provocation with 500 mcg of nitroglycerine.
Results: Total 153 patients, mean age 41.63+20.8, 103 males and 49 females. Mean BMI 23.54+5.66. Hypertension noted in 53 patients. Test was positive in 110 patients (72%) and negative in 39 (25.5%). Mean time to plain positive test was 28.87+8.75 minutes, [33.85+12.1 minutes (45 minutes plain) and 27.10+6.56 minutes (30 minutes plain)]; mean time to positive for all HUTT was 36.60+12.75 minutes. Mean baseline systolic and diastolic BP 126+22.73mmHg and 76.94+11.78 mmHg, respectively, mean baseline heart rate (HR) 74.2+15.04 bpm. Mean HR at positive was 57.01+19.24 bpm. A mean HR drop of 32.21 bpm, mean systolic BP drop of 38.91mmHg and a diastolic BP drop of 21.28mmHg. Symptoms for positive test were syncope 59, presyncope 49, 45 had other premonitory symptoms. Four had prolonged asystole (longest of 50 seconds), one supraventricular tachycardia, which reverted with carotid massage and one transient LBBB. A 9 year old boy (negative test) had absence seizure which could not be reproduced later with EEG. Hypertensive patients took a longer time to positive (mean time 31.56 minutes) as compared to normotensive patients (mean time 27.19 minutes) [p value of 0.04].
Conclusion: Hypertensive patients take a longer time for HUTT to become positive.
Keywords: HUTT, syncope, seasonal variation, hypertension
Head up tilt table test: a profile and association of hypertension with a positive test
Auditorium Pond Side
Background: Head up tilt test (HUTT) is an arguable gold standard. No data available from Pakistan. The test relies on vasodilatation. Hypertension would intuitively make a case for resisting positivity.
Aim: To look at the profile of HUTT and also see the association between hypertension with the time taken to positive test.
Materials and Methods: A retrospective study done at the Aga Khan University hospital. Details of all HUTTs between January 2002 and 2007 were recorded. HUTT protocols were 30 and 45 minutes plain tilt at 60 degrees and 15 minutes provocation with 500 mcg of nitroglycerine.
Results: Total 153 patients, mean age 41.63+20.8, 103 males and 49 females. Mean BMI 23.54+5.66. Hypertension noted in 53 patients. Test was positive in 110 patients (72%) and negative in 39 (25.5%). Mean time to plain positive test was 28.87+8.75 minutes, [33.85+12.1 minutes (45 minutes plain) and 27.10+6.56 minutes (30 minutes plain)]; mean time to positive for all HUTT was 36.60+12.75 minutes. Mean baseline systolic and diastolic BP 126+22.73mmHg and 76.94+11.78 mmHg, respectively, mean baseline heart rate (HR) 74.2+15.04 bpm. Mean HR at positive was 57.01+19.24 bpm. A mean HR drop of 32.21 bpm, mean systolic BP drop of 38.91mmHg and a diastolic BP drop of 21.28mmHg. Symptoms for positive test were syncope 59, presyncope 49, 45 had other premonitory symptoms. Four had prolonged asystole (longest of 50 seconds), one supraventricular tachycardia, which reverted with carotid massage and one transient LBBB. A 9 year old boy (negative test) had absence seizure which could not be reproduced later with EEG. Hypertensive patients took a longer time to positive (mean time 31.56 minutes) as compared to normotensive patients (mean time 27.19 minutes) [p value of 0.04].
Conclusion: Hypertensive patients take a longer time for HUTT to become positive.
Keywords: HUTT, syncope, seasonal variation, hypertension