title: [Early heart rate increase does not predict the result of the head-up tilt test potentiated with nitroglycerin].
abstract: OBJECTIVE
  The magnitude of the change in heart rate during the first few minutes of the head-up tilt test has been used to predict the test's result. The aim of this study was to investigate whether the heart rate increase during the head-up tilt test potentiated with nitroglycerin is related to the development of syncope.
  
  
  METHODS
  The study included 158 consecutive patients with syncope, with stable sinus rhythm, and without structural cardiac disease who were undergoing a head-up tilt test with nitroglycerin. The heart rate increment induced by the tilt maneuver and by nitroglycerin administration was calculated, and its relationship to clinical variables and to the test's results was analyzed.
  
  
  RESULTS
  The head-up tilt test gave positive results in 117 patients (74%). The heart rate was 68.7 (11.3) bpm in the decubitus position and 85.1 (15.4) bpm during the first 6 min of tilting. There was strong inverse correlation between the heart rate increase induced by tilting and age (r=--0.63; P<.001), but the increase (16.8 [9.3] bpm in patients with syncope versus 14.9 [11.3] bpm in those without; P=.3) did not predict the result of the test. The heart rate increase induced by nitroglycerin was also similar for patients with and without syncope during the pharmacologic phase of the test (27.3 [12.6] bpm and 26.7 (13.4) bpm, respectively; P=.8).
  
  
  CONCLUSIONS
  The magnitude of the heart rate increase during the first few minutes of tilt-testing and after nitroglycerin administration is inversely related to age but does not predict the result of the head-up tilt test with nitroglycerin.
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, España. arcadi@secardiologia.es
authors.forename: Arcadi
authors.initials: A
authors.lastname: García Alberola
authors.forename: Javier
authors.initials: J
authors.lastname: Lacunza Ruiz
authors.forename: José L
authors.initials: JL
authors.lastname: Rojo Alvarez
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Sánchez Muñoz
authors.forename: Juan
authors.initials: J
authors.lastname: Martínez Sánchez
authors.forename: Jesús
authors.initials: J
authors.lastname: Requena Carrión
authors.forename: Joaquín
authors.initials: J
authors.lastname: Barnés
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
mesh_terms: D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018667:Tilt-Table Test; D013997:Time Factors; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin