title: Role of Baroreflex Sensitivity in Predicting Tilt Training Response in Patients with Neurally Mediated Syncope.
abstract: OBJECTIVE
  An association between baroreflex sensitivity (BRS) and the response to tilt training has not been reported in patients with neurally mediated syncope (NMS). This study sought to investigate the role of BRS in predicting the response to tilt training in patients with NMS.
  
  
  METHODS
  We analyzed 57 patients who underwent tilt training at our hospital. A responder to tilt training was defined as a patient with three consecutive negative responses to the head-up tilt test (HUT) during tilt training.
  
  
  RESULTS
  After tilt training, 52 patients (91.2%) achieved three consecutive negative responses to the HUT. In the supine position before upright posture during the first session of tilt training for responders and non-responders, the mean BRS was 18.17 ± 10.09 ms/mm Hg and 7.99 ± 5.84 ms/mm Hg (p=0.008), respectively, and the frequency of BRS ≥ 8.945 ms/mm Hg was 45 (86.5%) and 1 (20.0%; p=0.004), respectively. Age, male gender, frequency of syncopal events before HUT, type of NMS, phase of positive HUT, total number of tilt training sessions, and mean time of tilt training did not differ between the study groups. In the multivariate analysis, BRS <8.945 ms/mm Hg in the supine position (odds ratio 23.10; 95% CI 1.20-443.59; p=0.037) was significantly and independently associated with non-response to tilt training.
  
  
  CONCLUSIONS
  The BRS value in the supine position could be a predictor for determining the response to tilt training in patients with NMS who are being considered for inpatient tilt training.
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kwang Jin
authors: KJ
authors: Chun
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hye Ran
authors: HR
authors: Yim
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jungwae
authors: J
authors: Park
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Seung Jung
authors: SJ
authors: Park
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kyoung Min
authors: KM
authors: Park
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Young Keun
authors: YK
authors: On
authors: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. juneskim@skku.edu.
authors: June Soo
authors: JS
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011187:Posture; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000503:physiopathology*; D018667:Tilt-Table Test / Q000379:methods*; D014230:Triazoles
chemical_list: D014230:Triazoles; C045950:propiconazole
keywords: Baroreflex sensitivity; neurally mediated syncope; tilt training