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Tilt table test

Tomaino M, Unterhuber M, Sgobino P, Pescoller F, Manfrin M, Rauhe W
In this study we wanted to verify the diagnostic value of tilt table test (TTT) to predict the efficacy of cardiac pacing (PM) for preventing recurrences of neurally mediated reflex syncope (NMS) in patients with cardioinhibitory activity (CI) documented by implantable loop recorder (ILR). Among patients selected by ILR in the context of severe clinical presentation of NMS, we analysed those who underwent PM implantation. In this observational and retrospective study we wanted to verify the results of TTT in the groups of treated patients with and without recurrences...
April 2016: Journal of Atrial Fibrillation
Jennifer E Posey, Rebecca Martinez, Jeremy E Lankford, James R Lupski, Mohammed T Numan, Ian J Butler
BACKGROUND: Orthostatic intolerance is typically thought to be sporadic and attributed to cerebral autonomic dysfunction. We sought to identify families with inherited autonomic dysfunction manifest as symptomatic orthostatic intolerance to characterize mode of inheritance and clinical features. METHODS: Sixteen families with two or more first- or second-degree relatives with autonomic dysfunction and orthostatic intolerance were enrolled. A clinical diagnosis of autonomic dysfunction defined by symptomatic orthostatic intolerance diagnosed by head-up tilt table testing was confirmed for each proband...
September 24, 2016: Pediatric Neurology
Jessica Robinson-Papp, Sandeep K Sharma, Mary Catherine George, David M Simpson
PURPOSE: Urban, minority communities are disproportionately affected by the chronic diseases associated with autonomic neuropathy; however validated measures of autonomic symptoms have not been studied in these complex populations. We sought to validate the Autonomic Symptom Profile (ASP) in a low income, medically complex, urban patient population. METHODS: Ninety-seven adults were recruited from the outpatient neurology clinic of an academic medical center serving the East Harlem neighborhood of New York City...
October 12, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Joong Seok Kim, Dong Woo Ryu, Ju Hee Oh, Yang Hyun Lee, Sung Jin Park, Kipyung Jeon, Jong Yun Lee, Seong Hee Ho, Jungmin So, Jin Hee Im, Kwang Soo Lee
BACKGROUND AND PURPOSE: Recent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients. METHODS: This study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring...
October 7, 2016: Journal of Clinical Neurology
In-Cheol Jeon, Oh-Yun Kwon, Jong-Hyuck Weon, Ui-Jae Hwang, Sung-Hoon Jung
CONTEXT: Prone hip extension has been recommended for strengthening the back and hip muscles. Previous studies have investigated prone hip extension conducted with subjects on the floor in the prone position. However, no study has compared three different table hip extension (THE) positions in terms of the activities of the back and hip joint muscles with lumbopelvic motion. OBJECTIVE: This study sought to identify more effective exercises for strengthening the gluteus maximus (GM) by comparing three different exercises [THE alone, THE with the abdominal drawing-in maneuver (THEA), and THEA with chair support under the knee (THEAC)] based on electromyographic muscle activity and pelvic compensation...
August 24, 2016: Journal of Sport Rehabilitation
Jittima Saengsuwan, Lucia Berger, Corina Schuster-Amft, Tobias Nef, Kenneth J Hunt
BACKGROUND: Exercise testing devices for evaluating cardiopulmonary fitness in patients with severe disability after stroke are lacking, but we have adapted a robotics-assisted tilt table (RATT) for cardiopulmonary exercise testing (CPET). Using the RATT in a sample of patients after stroke, this study aimed to investigate test-retest reliability and repeatability of CPET and to prospectively investigate changes in cardiopulmonary outcomes over a period of four weeks. METHODS: Stroke patients with all degrees of disability underwent 3 separate CPET sessions: 2 tests at baseline (TB1 and TB2) and 1 test at follow up (TF)...
September 6, 2016: BMC Neurology
Meihua Kang, Yi Xu, Runmei Zou, Lijia Wu, Ping Lin, Fang Li, Cheng Wang
OBJECTIVE: To explore the differences of Chinese people's age and gender in orthostatic hypertension (OHT) by a single-center experience study.
 METHODS: A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Yoshitomo Yanagimoto, Makoto Yamasaki, Hirotsugu Nagase, Takashi Kanemura, Shigeyoshi Higashi, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
Background and study aims: Gastric reflux into the remnant esophagus after subtotal or partial esophagectomy is associated with impairment in patient quality of life. We evaluated the feasibility, safety, and potential effectiveness of a novel procedure using a new endoscopic suturing device to create an anti-reflux valve (funnel) in pigs after esophagectomy with gastric tube reconstruction. Methods: The endoscopic procedure was performed in four pigs using a semi-full-thickness endoscopic suturing system (OverStitch; Apollo Endosurgery, Austin, Texas, USA)...
December 2016: Endoscopy
Alberto Porta, Beatrice De Maria, Vlasta Bari, Andrea Marchi, Luca Faes
OBJECTIVE: We test the hypothesis that the linear model-based (MB) approach for the estimation of conditional entropy (CE) can be utilized to assess the complexity of the cardiac control in healthy individuals. METHODS: A MB estimate of CE was tested in an experimental protocol (i.e. the graded head-up tilt) known to produce a gradual decrease of cardiac control complexity as a result of the progressive withdrawal and concomitant sympathetic activation. The MB approach was compared with traditionally exploited nonlinear model-free (MF) techniques such as corrected approximate entropy, sample entropy, corrected CE, two k-nearest-neighbor CE procedures and permutation CE...
August 16, 2016: IEEE Transactions on Bio-medical Engineering
Geoffrey L Heyer, Dara V F Albert, Amanda Weber, Satyanarayana Gedela, Jorge Vidaurre
We sought to characterize the clinical features of tilt-induced psychogenic nonsyncopal collapse (PNSC) from a cohort of young patients and to compare the semiologies between PNSC and EEG-confirmed psychogenic nonepileptic seizures (PNES). A PNSC diagnosis was made if a clinical event occurred during tilt-table testing that the patient regarded as fainting, but neither hypotension nor EEG changes were present. A diagnosis of PNSC was made in 17.6% of all patients referred during the 15-month study period. Cohorts with psychogenic nonsyncopal collapse (n=40) and PNES (n=40) did not differ in age (15...
September 2016: Epilepsy & Behavior: E&B
Giuseppe Frazzitta, Ilaria Zivi, Roberto Valsecchi, Sara Bonini, Sara Maffia, Katia Molatore, Luca Sebastianelli, Alessio Zarucchi, Diana Matteri, Giuseppe Ercoli, Roberto Maestri, Leopold Saltuari
BACKGROUND AND OBJECTIVE: Verticalization was reported to improve the level of arousal and awareness in patients with severe acquired brain injury (ABI) and to be safe in ICU. We evaluated the effectiveness of a very early stepping verticalization protocol on their functional and neurological outcome. METHODS: Consecutive patients with Vegetative State or Minimally Conscious State were enrolled in ICU on the third day after an ABI. They were randomized to undergo conventional physiotherapy alone or associated to fifteen 30-minute sessions of verticalization, using a tilt table with robotic stepping device...
2016: PloS One
Hugo F Posada-Quintero, John P Florian, Álvaro D Orjuela-Cañón, Ki H Chon
Time-domain indices of electrodermal activity (EDA) have been used as a marker of sympathetic tone. However, they often show high variation between subjects and low consistency, which has precluded their general use as a marker of sympathetic tone. To examine whether power spectral density analysis of EDA can provide more consistent results, we recently performed a variety of sympathetic tone-evoking experiments (43). We found significant increase in the spectral power in the frequency range of 0.045 to 0.25 Hz when sympathetic tone-evoking stimuli were induced...
September 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Funda Oztunc, Sezen Ugan Atik, Reyhan Dedeoglu, Firuze Erbek Alp, Selman Gokalp
Postural orthostatic tachycardia syndrome (POTS) is an abnormal heart rate response to a positional change. Several potential mechanisms for pathophysiology of POTS are defined. This syndrome can coexist with different clinical situations. In our report, the first case was a 13-year-old female who has been followed up for diagnosis of homocystinuria. She was admitted to our outpatient clinic with complaints of dizziness after suddenly moving from supine to upright position and chest pain after exercise. Tilt table test was performed to evaluate dizziness...
2016: Case Reports in Pediatrics
Tadashi Umehara, Atsuo Nakahara, Hiromasa Matsuno, Chizuko Toyoda, Hisayoshi Oka
Postprandial hypotension is one of the most important autonomic disorders in Parkinson's disease. However, its predictors remain unclear. We investigated which variable(s) predict the presence of postprandial hypotension in elderly patients with Parkinson's disease. The subjects were 64 patients with de novo Parkinson's disease who were 70 years or older. Postprandial hypotension was evaluated on a 75-g oral glucose tolerance test. Olfactory function, constipation, cardiac sympathetic or parasympathetic denervation, orthostatic intolerance on head-up tilt table testing, and other baseline characteristics were evaluated...
July 8, 2016: Journal of Neural Transmission
William Smith, Hong Wan, David Much, Antoine G Robinson, Patrick Martin
OBJECTIVE: Midodrine hydrochloride is a short-acting pressor agent that raises blood pressure in the upright position in patients with orthostatic hypotension. The US Food and Drug Administration's Subpart H approval, under which midodrine was initially approved, requires post-marketing studies to confirm midodrine's clinical benefit in this indication. The purpose of this study was to evaluate the clinical benefit of midodrine with regard to symptom response. METHODS: This was a double-blind, placebo-controlled, randomized, crossover, multicenter study (NCT01518946)...
August 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
T Umehara, A Nakahara, H Matsuno, C Toyoda, H Oka
OBJECTIVES: Patients with Parkinson's disease (PD) begin to lose weight several years before diagnosis, which suggests weight variation is associated with some factor(s) that precede the onset of motor symptoms. This study aimed to investigate the association of autonomic nervous system with body weight in patients with PD. MATERIALS AND METHODS: The subjects were 90 patients with early de novo PD. We examined the associations of body mass index (BMI) with sympathetic nervous activity reflected in orthostatic intolerance or cardiac uptake of (123) I-metaiodobenzylguanidine and parasympathetic nervous activity reflected in constipation or heart rate variability (HRV)...
June 30, 2016: Acta Neurologica Scandinavica
Aleksandra Gergont, Katarzyna Kurdziel, Urszula Stolarska-Weryńska
BACKGROUND: Neurocardiogenic syncope, the most common episodic event in children results from global cerebral hypoperfusion. Monitoring of the blood flow during head-up tilt-induced syncope resulted in registration of preferential reduction of end-diastolic velocities in middle cerebral arteries (MCA). The significance of those changes was however not explained. The aim of this retrospective research was to establish the significance of visual inspection of spectra changes of cerebral blood flow in MCA during presyncope and syncope in children...
2016: Przegla̧d Lekarski
Ashish Chaddha, Martina Rafanelli, Michele Brignole, Richard Sutton, Kevin E Wenzke, Stephen L Wasmund, Richard L Page, Mohamed H Hamdan
INTRODUCTION: Patients with vasovagal syncope (VVS) and positive tilt table test (TTT) were not found to benefit from pacing in the ISSUE-3 trial despite the presence of spontaneous asystole during monitoring. "Hypotensive susceptibility" unmasked by TTT was reported as a possible explanation. The purpose of this study was to assess the pathophysiologic mechanisms associated with hypotensive susceptibility. METHODS: 366 consecutive patients with the diagnosis of VVS who also had TTT were identified...
August 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Jasmine C Menant, Alfred K W Wong, Julian N Trollor, Jacqueline C T Close, Stephen R Lord
OBJECTIVES: To investigate risk factors for unexplained falls in older community-dwelling individuals. DESIGN: Prospective cohort study. SETTING: Community population, Sydney, Australia. PARTICIPANTS: Older adults (N = 529; mean age 79.8 ± 4.4, 52.2% female). MEASUREMENTS: Participants provided information demographic, medical, and medication characteristics and completed cardiovascular (tilt table test, pulse wave velocity), cognitive, and sensorimotor assessments at baseline...
May 2016: Journal of the American Geriatrics Society
Jin Yin, Bao-Gan Peng, Yong-Chao Li, Nai-Yang Zhang, Liang Yang, Duan-Ming Li
BACKGROUND: Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population. METHODS: A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group...
May 20, 2016: Chinese Medical Journal
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