Small left atrial volume is an independent predictor for fainting during head-up tilt test: The impact of intracardiac volume reserve in vasovagal syncope
- Authors
- Moon, Jeonggeun; Shim, Jaemin; Park, Jae Hyung; Hwang, Hye Jin; Joung, Boyoung; Ha, Jong-Won; Lee, Moon-Hyoung; Pak, Hui-Nam
- Issue Date
- 5-Jun-2013
- Publisher
- ELSEVIER IRELAND LTD
- Keywords
- Vasovagal syncope; Tilt test; Echocardiography; Left atrium
- Citation
- INTERNATIONAL JOURNAL OF CARDIOLOGY, v.166, no.1, pp.44 - 49
- Journal Title
- INTERNATIONAL JOURNAL OF CARDIOLOGY
- Volume
- 166
- Number
- 1
- Start Page
- 44
- End Page
- 49
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14465
- DOI
- 10.1016/j.ijcard.2011.09.076
- ISSN
- 0167-5273
- Abstract
- Background: Vigorous left ventricular (LV) contraction with progressive ventricular emptying during orthostatic stress may induce hyper-responsiveness of cardiac mechanoreceptor and vasovagal syncope (VVS). We hypothesized that intracardiac volume reserve estimated by the left atrial (LA) volume index (LAVI) plays an important role in the mechanism of VVS. Methods: A total of 234 patients (115 male, 44 +/- 18 years) who underwent head-up tilt test (HTT) and transthoracic echocardiography for unexplained syncope were consecutively enrolled. Patients with a positive HTT result (HTT+; n = 152) were compared with those with negative HTT response (HTT-; n = 82). Results: 1. Compared to HTT- patients, HTT+ patients were younger (41 +/- 17 vs. 48 +/- 17 years, p = 0.005), included a higher number of females (56% vs. 50%, p = 0.009) and showed higher basal heart rate (67 +/- 12 vs. 63 +/- 11 bpm, p = 0.047). 2. LAVI (20 +/- 5 vs. 26 +/- 13 ml/m(2), p < 0.001), LV end-diastolic dimension (47.4 +/- 3.7 vs. 49.0 +/- 4.1 mm, p = 0.015), and the proportion of LV hypertrophy (13% vs. 24%, p = 0.027) were smaller and early diastolic mitral annulus velocity was higher (9.7 +/- 3.0 vs. 8.5 +/- 2.6 cm/s, p = 0.004) in HTT+ patients than those in HTT - group. 3. LAVI (OR 0.917 (0.860-0.977), p = 0.007) was the only independent predictor of HTT induced VVS, and LAVI had a linear correlation with time to syncope during HTT (r = 0.39, p = 0.034). In addition, patients with LAVI >= 36 ml/m(2) did not faint during HTT. Conclusion: Small LA volume is an independent predictor of HTT- induced VVS. Limited intracardiac volume reserve might play an important role in the mechanism of VVS. (c) 2011 Elsevier Ireland Ltd. All rights reserved.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - ETC > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14465)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.