Tilt testing remains a valuable asset
European Heart Journal, vol. 42, pp. 1654–1660
Abstract
Head-up tilt test (TT) has been used for >50 years to study heart rate/blood pressure adaptation to positional changes, to model responses to haemorrhage, to assess orthostatic hypotension, and to evaluate haemodynamic and neuroendocrine responses in congestive heart failure, autonomic dysfunction, and hypertension. During these studies, some subjects experienced syncope due to vasovagal reflex. As a result, tilt testing was incorporated into clinical assessment of syncope when the origin was unknown. Subsequently, clinical experience supports the diagnostic value of TT. This is highlighted in evidence-based professional practice guidelines, which provide advice for TT methodology and interpretation, while concurrently identifying its limitations. Thus, TT remains a valuable clinical asset, one that has added importantly to the appreciation of pathophysiology of syncope/collapse and, thereby, has improved care of syncopal patients.
Authors 14
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Richard B. Sutton corresponding
Affiliation as printed
Department of Cardiology, Imperial College , London, UK
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Lund University · Skåne University Hospital
Affiliation as printed
Department of Cardiology , , Malmö, Sweden
Skåne University Hospital and Lund University , , Malmö, Sweden
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Affiliation as printed
Department of Cardiology, University of Iowa , Iowa City, IA, USA
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Neurology, Leiden University Medical Centre , The Netherlands
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University of Occupational and Environmental Health Japan
Affiliation as printed
Department of Heart Rhythm Management , , Kitakyushu, Japan
University of Occupational and Environmental Health , , Kitakyushu, Japan
Department of Heart Rhythm Management, University of Occupational and Environmental Health, Kitakyushu, Japan
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IRCCS Istituto Auxologico Italiano
Affiliation as printed
Istituto Auxologico Italiano, Faint & Fall Programme , Ospedale San Luca, Milano, Italy
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Amsterdam University Medical Centers · Amsterdam Cardiovascular Sciences · University of Amsterdam
Affiliation as printed
Amsterdam University Medical Centre, University of Amsterdam, Heart Centre , , Amsterdam, The Netherlands
Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences , , Amsterdam, The Netherlands
Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands
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Affiliation as printed
School of Medicine, Trinity College , Dublin, Ireland
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Hammersmith Hospital · Imperial College London
Affiliation as printed
Department of Cardiology , , London, UK
Hammersmith Hospital, Imperial College , , London, UK
Department of Cardiology, Hammersmith Hospital, Imperial College, London, UK
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Royal Brompton Hospital · Imperial College London
Affiliation as printed
National Heart & Lung Institute, Royal Brompton Hospital, Imperial College , London, UK
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Affiliation as printed
Department of Translational Sciences , , Naples, Italy
University of Campania , , Naples, Italy
Department of Translational Sciences, University of Campania, Naples, Italy
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Affiliation as printed
Department of Pediatrics , , Valhalla, NY, USA
New York Medical College , , Valhalla, NY, USA
Department of Pediatrics, New York Medical College, Valhalla, NY, USA
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Neurology, Leiden University Medical Centre , The Netherlands
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Affiliation as printed
Cardiac Arrhythmia Center, Cardiovascular Division , , Minneapolis, MN, USA
University of Minnesota , , Minneapolis, MN, USA
Cardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
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