Tekrarlayan Şüpheli Senkoplu Hastalarda Çift Doz Dilaltı Nitrogliserin ile Yapılan Eğik Masa Testinin Reprodusibilitesi

Giriş: Eğik masa testi senkop şüpheli hastalarda sıkça kullanılan bir testtir. Testin tanısal değeri ve reprodusibilitesi hakkında karşıt görüşler mevcuttur. Çeşitli serilerde pozitif bir testin reprodusibilitesi %36-90, negatif bir testin reprodusibilitesi ise %85-100 arasında bildirilmiştir. Biz bu çalışmada eğik masa testinin güncel reprodusibilitesini araştırmayı hedefledik. Hastalar ve Yöntem: Hastanemizde Mayıs 2017-Ocak 2019 tarihleri arasında çift doz sublingual sprey nitrogliserin ile test uygulanan tüm ardışık hastalar çalışmaya dahil edilmek üzere değerlendirildi. Çalışmaya katılmayı kabul eden hastalar ilk testten 1-7 gün sonra ikinci bir teste alındılar. Bulgular: Toplam 135 hasta [76 erkek (%56.3), 59 kadın (%43.7)] çalışmaya dahil edildi. Yaş aralığı 18- 61 ve ortalama yaş (± SD) 32 ± 10.85 idi. İlk testte 81 (%60.0) hastada pozitif sonuç, 51 (%37.8) hastada negatif sonuç ve 3 (%2.2) hastada nitrata abartılı yanıt saptandı. İkinci testte ise 75 (%55.6) hastada pozitif, 60 (%44.4) hastada negatif sonuç saptandı. Pozitif reprodusibilite %85.2, negatif reprodusibilite %88.2 ve toplam reprodusibilite %86.4 idi. Dilaltı nitratın yan etkilerine bağlı olarak test hiçbir hastada sonlandırılmadı. Sonuç: Seçilmiş hastalarda çift doz dilaltı sprey nitrogliserin ile yapılan eğik masa testinin güncel reprodusibilitesi yüksektir ve çift doz nitrogliserin kullanımı güvenilir olabilir.

Anahtar Kelimeler:

Senkop, eğik masa testi, eprodusibilite

Reproducibility of Tilt-Table Test Potentiated with Double Dose Sublingual Nitroglycerin in Patients with Suspected Recurrent Syncopal Episodes

Introduction: Tilt-table test (TT) is a noninvasive and safe test used for the diagnosis of patients with syncope. Currently, there are controversies about the diagnostic utility and reproducibility of TT. The reproducibility of TT has been reported within a wide range from 36% to 90% for a positive test and from 85% to 100% for a negative test. The aim of the present study was to investigate the current reproducibility of TT. Patients and Methods: All consecutive patients who underwent TT with double dose spray nitroglycerin due to suspected reflex syncope between May 2017 and January 2019 at our hospital were evaluated. Patients underwent a second TT within 1-7 days following the initial test. Results: A total of 135 (76 female, 56.3% and 59 male, 43.7%) patients aged 18-61 (mean (± SD) 32 ± 10.85) years were included in the study. In the first test, 81 (60.0%) patients had a positive response, 51 (37.8%) patients had a negative response, and 3 (2.2%) patients had an exaggerated response. In the repeated test, 75 (55.6%) patients had a positive response, and 60 (44.4%) patients had a negative response. The reproducibility of a positive tilt test was 85.2%, whereas the reproducibility of a negative tilt test was 88.2%. Overall reproducibility was 86.4%. Conclusion: In selected patients, TT with double dose sublingual spray nitroglycerin has a high reproducibility. Double dose sublingual spray nitroglycerin might be used for potentiating TT with acceptable safety.

Keywords:

Syncope, tilt-table test, reproducibility,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi