Long-Term Effects of Pharmacological Therapy for Vasovagal Syncope on the Basis of Reproducibility During Head-Up Tilt Testing

• NAKAGAWA Haruyuki

  The Third Department of Internal Medicine, Showa University School of Medicine

• KOBAYASHI Youichi

  The Third Department of Internal Medicine, Showa University School of Medicine

• KIKUSHIMA Shuji

  The Third Department of Internal Medicine, Showa University School of Medicine

• SHINOHARA Makoto

  The Third Department of Internal Medicine, Showa University School of Medicine

• OBARA Chiaki

  The Third Department of Internal Medicine, Showa University School of Medicine

• ZINBO Yoshihiro

  The Third Department of Internal Medicine, Showa University School of Medicine

• CHIYODA Kazumi

  The Third Department of Internal Medicine, Showa University School of Medicine

• MIYATA Akira

  The Third Department of Internal Medicine, Showa University School of Medicine

• TANNO Kaoru

  The Third Department of Internal Medicine, Showa University School of Medicine

• BABA Takao

  The Third Department of Internal Medicine, Showa University School of Medicine

• KATAGIRI Takashi

  The Third Department of Internal Medicine, Showa University School of Medicine

抄録

The purpose of this study was to determine the efficacy of long-term pharmacological therapy selected on the basis of a head-up tilt test(HUT)in patients in whom reproducibility of the HUT response was demonstrable in the initial study. The HUT(80゜ upright)was performed for 15 min with or without an infusion of isoproterenol(0.01-0.03μg/kg per min)in 54 patients with recurrent unexplained syncope. When vasovagal syncope was induced(positive response), the HUT was repeated to examine the test reproducibility. Vasovagal syncope was induced in 24 patients during HUT alone, and in 30 patients during the HUT with isoproterenol. Acute reproducibility was observed in 49/54(91%)patients. In the tilt-positive patients, HUT was repeated after an intravenous administration of propranolol(0.1mg/kg)or disopyramide(1 mg/kg)(acute test). Propranolol proved effective in 21(80%)of 26 patients, and disopyramide in 13(56%)of 23 patients. Thereafter, evaluation was done on the long-term clinical follow-up of the pharmacological intervention selected on the basis of the acute test in the 34 patients in whom the HUT could not induce vasovagal syncope after the oral administration of the pharmacological agent(propranolol 60 mg/day, disopyramide 300 mg/day). Thirty-two of 34 patients(94%)did not develop syncopal attacks during a 44±12-month period. Thus, in patients with unexplained syncope, HUT appears to have a high degree of acute reproducibility, and the acute drug response guided by HUT may be used to develop an effective long-term pharmacological therapy.

収録刊行物

• Japanese circulation journal

  Japanese circulation journal 62 (10), 727-732, 1998-09-20

  社団法人日本循環器学会

キーワード

• Disopyramide
• Head-up tilt test
• Isoproterenol
• Propranolol
• Reproducibility
• Vasovagal syncope

詳細情報

• CRID: 1570854177220825344
• NII論文ID: 110002561096
• NII書誌ID: AA00690731
• ISSN: 00471828
• Web Site: https://search.jamas.or.jp/link/ui/1999052996
• 本文言語コード: en
• データソース種別:
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