The effect of orthostatic training in the prevention of vasovagal syncope and its influencing factors.

Recently orthostatic training has been proposed as an effective treatment for vasovagal syncope, even though some patients may relapse. This study was undertaken to assess the effect of orthostatic training on patients with vasovagal syncope and its influencing factors. The study group comprised 125 consecutive patients (51 males and 74 females), aged 40 +/- 19 years, with a history of syncope and a positive head-up tilt test. They were randomized into an orthostatic training group (64 patients) and a no treatment group (controls, 61 patients). The training programme consisted of daily 30-minute sessions of upright standing against a vertical wall 6 days a week for at least 4 weeks. After one year of follow-up, 45 (72.6%) of 62 orthostatic trained patients reported no syncopal recurrence, while only 22 of 61 controls (36.1%, P < 0.05) reported the same. Furthermore, in the training group, the patients with recurrence were older, and the number of syncopal spells in the preceding year was less than in the patients with no recurrence in the same group. Orthostatic training is an effective therapy for the prevention of vasovagal syncope. This kind of therapy was of greater benefit to patients who were younger or experienced frequent spells of syncope.

[Factors related to false positive results of treadmill electrocardiogram test for the detection of coronary heart disease].

OBJECTIVE: To investigate the clinical factors related to false positive results of electrocardiogram treadmill exercise test (TET) for the detection of coronary heart disease (CHD). METHODS: 258 patients with chest pain undergoing TET and coronary angiography (CAG) were on rolled. The case history and various clinical parameters were collected. (1) The results of TET and CAG were compared to evaluate the sensitivity, specificity and accuracy of TET; (2) Clinical informations of the true positive group and the false positive group were compared and a statistic analysis was carried out. RESULTS: The sensitivity, specificity and accuracy of TET for diagnosing CHD was 77.3%, 65.9%, and 69.8% respectively. The number of female in the false positive group was larger than that in the true positive group; The number of patients with typical chest pain, hyperlipidemic history, smoking history and family history of CHD was smaller than that in the true positive group. In the false positive group, the change of ST segment was mainly in II, III, aVF. The number of patients with change of more than 0.2 mV in ST and with angina induced during exertion was lower in the false positive group than in the true positive group. The difference was significant. CONCLUSION: Factors including sex, typical chest pain, risk factors of CHD, the location and extent of ECG changes and angina induced by exertion are closely related to false positive results of TET.