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Prognostic Factors of Neurocardiogenic Syncope in Young Patients
국군수도병원 순환기내과¹ , 가톨릭대학교 의과대학 순환기내과²
엄재선¹, 윤호중² , 박경일¹ , 정우백² , 박정환² , 오수성² , 정종원² , 이동현² , 최윤석² , 오용석² , 정욱성²
Background: Neurocardiogenic syncope is the most common cause of syncope in patients without underlying diseases. Headup tilt test (HUTT) is widely used to diagnose neurocardiogenic syncope. Any prognostic factors are not known for predicting recurrence of syncope in patients with neurocardiogenic syncope. The aim of this study was to elucidate the prognostic factors of neurocardiogenic syncope in young patients diagnosed with HUTT. Methods: HUTT was performed with 444 subjects (mean age, 22.0 ± 4.08; 437 men) according to modified Westminster protocol. We analyzed the frequency of syncope before HUTT, the time interval between the last episode and HUTT, the duration of HUTT, the type of neurocardiogenic syncope (type 1: mixed, type 2A and 2B: cardioinhibitory, type 3: vasodepressor) and the recurrence of syncope within 3 months among the patients with positive HUTT results. Results: 206 patients showed positive results in HUTT. Among them, 130 patients (mean age, 21.3 ± 1.71; 125 men) were followed up for 3 months. Type 1 was 78 (60%), type 2A was 7 (5.4%), type 2B was 20 (15.4%), and type 3 (vasodepressor) was 25 patients (19.2%). By multivariate analysis, the frequency of syncope before HUTT and the duration of HUTT were significantly related to the recurrence of syncope (p = 0.005, p = 0.011, respectively). Types of neurocardiogenic syncope, and the time interval between the last episode and HUTT were not significantly related to the recurrence of syncope. Conclusion: The frequency of syncope before HUTT and the duration of HUTT are the important prognostic factors of predicting the recurrence of syncope.

 

Frequency of syncope (time)

Duration of HUTT (min)

1

2

<30

30

Recurrence (time)

0.19±0.65

0.63±1.31

0.04±0.20

0.51±1.17

p value

0.005

0.011

HUTT; headup tilt test


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