Relationship between sarcopenia and orthostatic hypotension

Abstract Background The relationship between sarcopenia and orthostatic hypotension (OH) is unclear. Objectives The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH. Design A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis. Results The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98–10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31–14.15; P = 0.016 for OH1; OR 4.09, CI 1.01–16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87–8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05). Conclusions There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.

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The Differences in the Diagnostic Profile in Children with Vasovagal Syncope between the Result of Head-Up Tilt Table Test

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124524 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4524

Author(s):

Ewelina Kolarczyk ◽

Lesław Szydłowski ◽

Agnieszka Skierska ◽

Grażyna Markiewicz-Łoskot

Keyword(s):

Medical Records ◽

Vasovagal Syncope ◽

Speech Disorders ◽

Tilt Table Test ◽

Tilt Table ◽

Prodromal Symptoms ◽

Close Relationship ◽

Head Up Tilt ◽

Diagnostic Profile ◽

Positive Results

(1) Background: The features characterizing vasovagal syncope (VVS) are an important factor in the correct evaluation of diagnostic risk stratification in children and adolescents. The aim of the study was to determine the value of identifying the clinical characteristics in children with VVS. (2) Methods: We made a retrospective analysis of the medical records of 109 children with diagnosed VVS. We investigated the specific characteristics of syncope in children with VVS including the positive VVS (+) and negative VVS (−) result of the Head-Up Tilt Table Test (HUTT). (3) Results: We did not observe significant differences in the prodromal symptoms of VVS with HUTT response. In addition to typical prodromal symptoms, no difference in statistically reported palpitations (35/109 or 32.1%) and chest discomfort (27/109 or 27.7%) were recorded. Fear–pain–stress emotions as circumstances of syncope were more often reported by children with a negative HUTT (p = 0.02). Cramps–contractures (p = 0.016) and speech disorders (p = 0.038) were significantly higher in the group with negative HUTT. (4) Conclusions: There is a close relationship in the diagnostic profile between the negative and positive results of head-up tilt table test in children with vasovagal syncope.

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Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test?

Clinical Interventions in Aging ◽

10.2147/cia.s129868 ◽

2017 ◽

Vol Volume 12 ◽

pp. 207-212 ◽

Cited By ~ 19

Author(s):

Ali Ekrem AYDIN ◽

PINAR SOYSAL ◽

Ahmet Turan ISIK

Keyword(s):

Older Adults ◽

Orthostatic Hypotension ◽

Tilt Table Test ◽

Tilt Table ◽

Head Up Tilt ◽

Standing Test

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Correlation of head-up tilt table test time interval with risk of recurrent syncope

Indian Heart Journal ◽

10.1016/j.ihj.2015.10.189 ◽

2015 ◽

Vol 67 ◽

pp. S77

Author(s):

R.K. Gokhroo ◽

Kumari Priti ◽

A. Avinash ◽

Bhanwar Lal Ranwa ◽

Kamal Kishor ◽

...

Keyword(s):

Test Time ◽

Time Interval ◽

Tilt Table Test ◽

Tilt Table ◽

Head Up Tilt

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Repolarization disparity as a predictor of response to Head Up Tilt‐table Test in pediatric syncope

Pacing and Clinical Electrophysiology ◽

10.1111/pace.14305 ◽

2021 ◽

Author(s):

Mohammad Reza Khalilian ◽

Abdolrahim Ghasemi ◽

Narges Khazaei ◽

Sara Khoshkhou ◽

Elham Mahmoudi

Keyword(s):

Tilt Table Test ◽

Tilt Table ◽

Head Up Tilt

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Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02087-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Javier Jiménez-Candil ◽

Olga Duran ◽

Armando Oterino ◽

Jendri Pérez ◽

Juan Carlos Castro ◽

...

Keyword(s):

At Risk ◽

Secondary Prevention ◽

Beta Blocker ◽

Cycle Length ◽

Close Relationship ◽

Appropriate Therapy ◽

The Mean ◽

Ventricular Tachycardias ◽

The Relationship

Abstract Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF < 45% were studied. ICD programming was standardized. NSVT was defined as any VT of 5 or more beats at ≥ 150 bpm occurred in the first 6 months after implantation that terminated spontaneously and was not preceded by any appropriate therapy. The mean follow-up was 41 ± 27 months. Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p < 0.001), number of NSVT episodes (HR = 1.05; 95% CI 1.04–1.07; p < 0.001) and beta-blocker treatment (HR = 0.7; p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p < 0.001. This correlation was especially robust in individuals with > 5 NSVTs (r = 0.97; p < 0.001), with an agreement between both values greater than 95%. Patients with any fast NSVT experienced a higher incidence of VF episodes (26%) compared to those without NVSTs (3%) or with only slow NSVTs (7%); p < 0.001. Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.

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Mitochondrial insufficiency is associated with autonomic nervous system dysfunction as confirmed by physiologic Head up Tilt table test (HUTT)

Mitochondrion ◽

10.1016/j.mito.2013.07.055 ◽

2013 ◽

Vol 13 (6) ◽

pp. 918-919

Author(s):

Mohammed Numan ◽

Ian Butler ◽

Rebecca Martinez ◽

Melissa Knight ◽

Nada Memon ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Tilt Table Test ◽

Tilt Table ◽

Autonomic Nervous System Dysfunction ◽

Autonomic Nervous ◽

Head Up Tilt

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Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186441 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6441

Author(s):

Grażyna Markiewicz-Łoskot ◽

Ewelina Kolarczyk ◽

Bogusław Mazurek ◽

Marianna Łoskot ◽

Lesław Szydłowski

Keyword(s):

Vasovagal Syncope ◽

The Other ◽

Control Group ◽

Tilt Table Test ◽

Tilt Table ◽

T Wave ◽

Good Discriminator ◽

Wave Morphology ◽

Head Up Tilt ◽

T Waves

The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer (p < 0.001) compared to the other test phases and longer (p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter (p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

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