Arrhythmias & electrophysiologyCohort study
Aetiology and haemodynamic patterns of orthostatic hypotension in a tertiary syncope unit
- Retrospective cohort study
- tertiary syncope unit
Authors' conclusion
One-half of highly symptomatic OH patients had mixed OH, whereas one-quarter had either pure neurogenic or non-neurogenic OH, respectively. Different forms of OH were indifferentiable based on haemodynamic responses during TTT, questioning the clinical utility of such classification.
Study context
- Population
- Patients referred for unexplained syncope or highly symptomatic orthostatic intolerance with tilt table test (TTT)-verified classical orthostatic hypotension (OH)
- Participants
- 52 good-quality TTT recordings
- Exposure
- Neurogenic OH (nOH) vs non-nOH vs mixed OH
- nOHn = 12reference
- non-nOHn = 14
- mixed OHn = 26
- Outcome
- Decrease in mean arterial pressure (MAPLR, log-ratio method) and contributions of HR, stroke volume and total peripheral resistance during upright TTT
- Follow-up
- 4th upright minute of TTT
Main finding
As reported in the abstract
MAPLR
nOH
−0.10
± 0.04
non-nOH
−0.07
± 0.05
mixed OH
−0.06
± 0.05
- No difference in MAPLR among the three groups
- P = 0.10
- Contributions of HRLR, SVLR and total peripheral resistance (TPRLR) to the drop in MAPLR did not differ between groups
- all P > 0.05
Observational data: associations, not effects.
Further findings
Prevalence of cOH aetiology
Original publication
Aetiology and haemodynamic patterns of orthostatic hypotension in a tertiary syncope unit. Europace. Published 17 January 2025. doi:10.1093/europace/euaf017
Summarised from the published abstract; every number is checked against it