ABSTRACT
Objective To investigate the diagnostic value of head-up tilt test (HUT) in cough syncope (CS).Methods Forty-seven outpatients or inpatients with CS and 79 patients with suspected vasovagal syncope(SVVS) due to syncope history in our hospital from January 2011 to May 2015 served as the observation group and control group respectively.HUT was performed in the two groups.The cough response during HUT,changes of systolic pressure and diastolic pressure caused by cough,HUT positive results and hemodynamic type were observed,Results In the observation group,4 cases(8.51％) were cough caused syncope,26 cases (55.32 ％) were presyncope and 17 cases (36.17 ％) had no symptoms,while 79 cases in the control group had no symptoms,the differences were statistically significant (P＜ 0.05).The total positive rate of cough response in the observation group was 63.83％,and the specificity was 100.00％.The systolic blood pressure had statistical difference between the two groups(.P＜0.05).The diastolic pressure had statistical difference between the cases of non-symptoms with the cases of syncope and cases of presyncope in the observation group (P＜0.05),but had no statistical difference compared with the cases of non-symptoms in the control group(P＞0.05).The heart rate(HR) had no statistical difference among various groups(P＞0.05).The HUT positive rate in the observation group was lower than that in the control group(P＜0.05).The hemodynamic type had no statistical difference between the two groups(P＞0.05).Conclusion Severe coughing during HUT may cause the blood pressure decrease,induces syncope or presyncope,can increase the diagnostic sensitivity of CS patients,which is very useful in the suspected diagnosis of CS patients,especially for CS patients with a unclear history.
ABSTRACT
Objective To investigate the diagnostic value of head-up tilt test (HUT) in cough syncope (CS).Methods Forty-seven outpatients or inpatients with CS and 79 patients with suspected vasovagal syncope(SVVS) due to syncope history in our hospital from January 2011 to May 2015 served as the observation group and control group respectively.HUT was performed in the two groups.The cough response during HUT,changes of systolic pressure and diastolic pressure caused by cough,HUT positive results and hemodynamic type were observed,Results In the observation group,4 cases(8.51％) were cough caused syncope,26 cases (55.32 ％) were presyncope and 17 cases (36.17 ％) had no symptoms,while 79 cases in the control group had no symptoms,the differences were statistically significant (P＜ 0.05).The total positive rate of cough response in the observation group was 63.83％,and the specificity was 100.00％.The systolic blood pressure had statistical difference between the two groups(.P＜0.05).The diastolic pressure had statistical difference between the cases of non-symptoms with the cases of syncope and cases of presyncope in the observation group (P＜0.05),but had no statistical difference compared with the cases of non-symptoms in the control group(P＞0.05).The heart rate(HR) had no statistical difference among various groups(P＞0.05).The HUT positive rate in the observation group was lower than that in the control group(P＜0.05).The hemodynamic type had no statistical difference between the two groups(P＞0.05).Conclusion Severe coughing during HUT may cause the blood pressure decrease,induces syncope or presyncope,can increase the diagnostic sensitivity of CS patients,which is very useful in the suspected diagnosis of CS patients,especially for CS patients with a unclear history.
ABSTRACT
Objective To observe the curative effect of continuous airway positive pressure ventilation (CPAP) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and cough syncope. Methods Forty-three hospitalized patients with OSAHS and cough syncope were collected in the Department of Respiration of Tianjin General Hospital, and analyzed the related information. They were given CPAP treatment, and were divided into good compliance group (n=26) and poor compliance group (n=17) according to CPAP compliance after a half-year treatment. The apnea hypoventilation index (AHI) and c-reactive protein (CRP) were compared before and after treatment between two groups. Results The positive correlation was found between the frequency of the cough syncope and indicators of OSAHS, such as AHI, body mass index (BMI), CRP, sleepiness score (ESS) and circumference of abdomen and neck (r=0.612, 0.431, 0.224, 0.654, 0.435 and 0.344,P<0.05). All these patients were cured after the treatment of both CPAP and medication for 1 or 2 weeks. During a half-year follow-up, the cough syncope didn’t occur in those patients of good compliance group, otherwise cough syncope still happened but with less frequency in patitents of poor compliance group. Before the treatment , there was no significant difference in AHI (45.00±15.69 vs. 48.70±16.47) and CRP (3.46± 1.15 vs. 3.38±0.72) between the two groups. After treatment, AHI (26.97±14.06 vs. 48.18±15.96) and CRP (1.56±0.76 vs. 3.18± 0.78) were significantly lower in the good compliance group than those of the poor compliance group (P<0.01). Conclusion Timely and sustained treatment of OSAHS may help reduce the incidence of cough syncope and significantly improve AHI, CRP and cough symptoms.