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Amitrano D., Ammendola E., Cavallaro C., Santangelo L.
Dipartimento di Scienze Cardiotoraciche e Respiratorie, Seconda Università degli Studi di Napoli, A.O. Monaldi, Napoli
Aim. We have presumed that patients who are positive for vasovagal syncope during the head-up tilt test (HUTT) present various changes in overall ventricular function post-tilt compared to normal subjects. The purpose of the study was to evaluate the parameters of the left ventricular function and haemodynamic adaptations during HUTT syncope induced by means of the use of ambulatorial monitoring with a radionuclid measurement system of left ventricular function (LVF).
Methods. Ten patients (group 1), 5 male and 5 female, of mean age 33+/-15, with a history of recurrent syncopes of indeterminate nature were studied during HUTT using out-patient scintigraphic monitoring of LVF and were compared with 5 control subjects (group 2). The scintigraphic variables obtained were the ejection fraction (EF), systolic volume (SV), telediastolic volume (EDV) and telesystolic volume (ESV).
Results. At the end of the HUTT the SV had increased in group 1 (p=0.04) and the EF had also increased in group 1 (p=0.03).
Conclusion. the changes in the scintigraphic variables are compatible with a sympathetic cardiac response, especially in HUTT (+) patients. All this may explain how sympathetic hyperactivity activates the vagal hypertone that causes the syncope in HUTT (+) patients.