Skip Navigation

European Heart Journal 2001 22(6):497-503; doi:10.1053/euhj.1999.2007
Copyright © 2001 by the European Society of Cardiology.
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow References
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (14)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Graham, L.A
Right arrow Articles by Kenny, R.A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Graham, L.A
Right arrow Articles by Kenny, R.A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Comparison of provocative tests for unexplained syncope: isoprenaline and glyceryl trinitrate for diagnosing vasovagal syncope

L.A Grahama, J.C Grayb and R.A Kennya,f1

a Cardiovascular Investigation Unit, Royal Victoria Infirmary, Newcastle upon Tyne, U.K.
b Centre for Health and Medical Research, University of Teesside, Newcastle upon Tyne, U.K.

revised October 28, 1999; accepted November 2, 1999

Abstract

Aims To compare the sensitivity, specificity and adverse event profile of glyceryl trinitrate head-up tilt with isoprenaline head-up tilt in the diagnosis of vasovagal syncope in patients with unexplained syncope and healthy controls

Methods and Results Forty-eight patients with unexplained syncope and negative passive head-up tilt at 70 degrees for 40min, and 14 healthy controls underwent glyceryl trinitrate head-up tilt and isoprenaline head-up tilt (maximum dose 5µg.min–1) one week apart in random order. Outcome measures were production of symptoms (syncope, pre-syncope) with development of hypotension. In those with negative passive head-up tilt, the sensitivity of glyceryl trinitrate for diagnosing vasovagal syncope was 48% and the specificity was 71%. Glyceryl trinitrate was well tolerated. Isoprenaline sensitivity was 21% with specificity 64%. Side-effects prevented completion of the test in 68%. Commonest adverse events were the development of hypertension or tachycardia and intolerable flushing or nausea.

Conclusions Glyceryl trinitrate head-up tilt is as effective as isoprenaline head-up tilt as a provocative agent for vasovagal syncope and has a lower incidence of adverse events

Key Words: Syncope, vasovagal syndrome, head-up tilt testing

f1 Correspondence: Professor R. A. Kenny, MD, FRCP(I), FRCP, Cardiovascular Investigation Unit, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, U.K.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
S W Parry, P Reeve, J Lawson, F E Shaw, J Davison, M Norton, R Frearson, S Kerr, and J L Newton
The Newcastle protocols 2008: an update on head-up tilt table testing and the management of vasovagal syncope and related disorders
Heart, March 1, 2009; 95(5): 416 - 420.
[Full Text] [PDF]

Home page
 Age AgeingHome page
S. W. Parry, J. C. Gray, J. L. Newton, P. Reeve, D. O'shea, and R. A. Kenny
'Front-loaded' head-up tilt table testing: validation of a rapid first line nitrate-provoked tilt protocol for the diagnosis of vasovagal syncope
Age Ageing, July 1, 2008; 37(4): 411 - 415.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
P. Bordier, M. Colsy, F. Robert, and G. Bourenane
Prevalence of positive carotid sinus massage and related risk of syncope in patients with Alzheimer's disease
Europace, September 1, 2007; 9(9): 829 - 834.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
Guidelines on Management (diagnosis and treatment) of syncope - update 2004: The Task Force on Syncope, European Society of Cardiology
Europace, January 1, 2004; 6(6): 467 - 537.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.