title: An association between anxiety and neurocardiogenic syncope during head-up tilt table testing.
abstract: To study the association between anxiety and neurocardiogenic syncope as determined by head-up tilt table testing (HUT) in men and women with presyncope or syncope, patients with unexplained syncope or presyncope undergoing HUT were asked to complete the Burns Anxiety Inventory (BAI), a validated inventory of 33 questions with responses graded from 0 to 3. HUT consisted of a 30-minute tilt to 60 degrees, which if negative, was repeated with an isoproterenol infusion. A positive HUT was defined as symptomatic hypotension and/or bradycardia. Of the 66 patients who completed the BAI and underwent HUT, 33 were men and 33 were women. The mean age was 57 +/- 18 years (17-91 years). Patients with a positive HUT had a higher BAI score than those with a negative HUT (22 +/- 12 vs 14 +/- 13, P = 0.017). This association was stronger in women with a BAI score of 24 +/- 11 in those with a positive HUT versus 13 +/- 8 in those with a negative HUT (P = 0.005). In contrast, the mean BAI score for men with a positive HUT was 19 +/- 13, as compared to 15 +/- 16 for a negative HUT (P = 0.5). In conclusion, the present study demonstrates a statistical association between anxiety (as determined by BAI) and HUT result. Gender-based analysis revealed a more statistically significant relationship between anxiety and HUT outcome for women as compared to men.
authors.affiliation: Department of Medicine, Winthrop-University Hospital, Mineola, New York, USA. tcohen@winthrop.org
authors.forename: T J
authors.initials: TJ
authors.lastname: Cohen
authors.forename: N
authors.initials: N
authors.lastname: Thayapran
authors.forename: B
authors.initials: B
authors.lastname: Ibrahim
authors.forename: C
authors.initials: C
authors.lastname: Quan
authors.forename: W
authors.initials: W
authors.lastname: Quan
authors.forename: F
authors.initials: F
authors.lastname: von zur Muhlen
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012737:Sex Factors; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D018667:Tilt-Table Test / Q000523:psychology*