The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Twenty-eight years of research permit reinterpretation of tilt-testing: hypotensive susceptibility rather than diagnosis
Abstract
There is growing scepticism over utility of tilt-testing for syncope diagnosis, which has been shown unable to distinguish vasovagal from other syncope, especially cardiac, despite its acceptable sensitivity and specificity in true positive and negative subjects. The new interpretation is that the test reveals a susceptibility to reflex hypotension, which may exist in coincidence with any cause of syncope. This implies an important change in patient management including selecting effective therapy, in particular in guiding pacemaker therapy in patients affected by reflex syncope.
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“In these patients, a positive tilt test reveals a susceptibility to orthostatic stress. 132”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [132]
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040
Self-citationHEAD-UP TILT: A USEFUL TEST FOR INVESTIGATING UNEXPLAINED SYNCOPE
Kenny, R. A., Bayliss, J. M., Ingram, A., & Sutton, R. (1986) · The Lancet · doi:10.1016/s0140-6736(86)91665-x · Cited by 777
Self-citationPASSIVE IMMUNITY AGAINST CHILDHOOD CANCER
Lowry, W. S. (1974) · The Lancet · doi:10.1016/s0140-6736(74)90736-3 · Cited by 518
Brignole, M., Menozzi, C., Moya, A., Andresen, D., Blanc, J. J., Krahn, A. D., Wieling, W., Beiras, X., Deharo, J. C., Russo, V., et al. (2012) · Circulation · doi:10.1161/circulationaha.111.082313 · Cited by 437
Self-citationMethodology of head-up tilt testing in patients with unexplained syncope
Fitzpatrick, A. P., THEODORAKIS, G. N., Vardas, P. E., & Sutton, R. (1991) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(91)90714-k · Cited by 428
Self-citationBartoletti, A. (2000) · Europace · doi:10.1053/eupc.2000.0125 · Cited by 315
Raviele, A., Menozzi, C., Brignole, M., Gasparini, G., Alboni, P., Musso, G., Lolli, G., Oddone, D., Dinelli, M., & Mureddu, R. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80079-4 · Cited by 249
Self-citationLeitch, J. W., Klein, G. J., Yee, R., Leather, R. A., & Kim, Y. H. (1992) · Circulation · doi:10.1161/01.cir.85.3.1064 · Cited by 171
Brignole, M., Donateo, P., Tomaino, M., Massa, R., Iori, M., Beiras, X., Moya, A., Kus, T., Deharo, J. C., Giuli, S., et al. (2014) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.113.001103 · Cited by 127
Self-citationRole of autonomic reflexes in syncope associated with paroxysmal atrial fibrillation
Brignole, M., Gianfranchi, L., Menozzi, C., Raviele, A., Oddone, D., Lolli, G., & Bottoni, N. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90426-2 · Cited by 114
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Research works printed but not linked: 1
- 1998, J AMCOLLCARDIOL, 31, 1377
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2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab364 · Cited by 2,019
Self-citation2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
Self-citation2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · EP Europace · doi:10.1093/europace/euab232 · Cited by 936
Self-citationCardiac pacing in severe recurrent reflex syncope and tilt-induced asystole
Brignole, M., Russo, V., Arabia, F., Oliveira, M., Pedrote, A. A., AERTS, A. J. J., Rapacciuolo, A., Bovéda, S., Deharo, J., Maglia, G., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa936 · Cited by 121
Self-citationThijs, R. D., Brignole, M., Falup‐Pecurariu, C., Fanciulli, A., Freeman, R. L., Guaraldi, P., Jordan, J., Habek, M., Hilz, M. J., Traon, A. P., et al. (2021) · Clinical Autonomic Research · doi:10.1007/s10286-020-00738-6 · Cited by 112
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Metadata
- Authors
- Sutton, R., & Brignole, M.
- Affiliations
- Imperial College London (GB)
- Presidio Ospedaliero (IT)
- Corresponding author
- Sutton, R.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-06-30
- Volume
- 35
- Issue
- 33
- Pages
- 2211-2212
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2023173182
- Cited by
- 127
- References
- 22
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 11 · 2022: 9 · 2021: 19 · 2020: 14 · 2019: 12 · 2018: 12 · 2017: 10 · 2016: 9 · 2015: 10 · 2014: 5
- FWCI
- 11.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- tilt table test, syncope, vasovagal syncope, cardiac syncope, reflex syncope, pacemaker therapy, sensitivity and specificity, test interpretation
- MeSH terms
- Diagnosis, Differential, Disease Susceptibility, Humans, Hypotension, Sensitivity and Specificity, Syncope, Tilt-Table Test
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