Tilt Table Testing

摘要: Pathophysiological studies of tilt table aided orthostatic stress on humans were fifty years old before the evolution head-upright testing into diagnostic test choice in vasovagal syncope. Variations tolerance demonstrated by observed normal subjects1,2 and association with pregnancy,3 anxiety,4 prolonged inactivity5,6 immersion.7 Tilt was also used assessment physiologic responses to stress,8,9 weightlessness10 parachuting11 workers aerospace aviation medicine. Throughout these investigations, orthostasis noted provoke syncope subgroups those studied subsequently investigate several components response, notably cardiac output,12,13 changes forearm blood flow14 venous tone.15 Several authors commented occurrence varying proportions subjects studied,1,3,8,11,15 while others an increase frequency during tilting a history suggestive syndrome.11,16 It not until 1986, however that intellectual leap from interesting clinical observation utility made, publication Westminster group’s landmark study usefulness head-up diagnosis unexplained syncope.17 In this series,17 67% patients otherwise developed syncopal symptoms associated hypotension bradycardia tilt. Only 10% asymptomatic controls had similar reactions. The has since withstood extensive experimental scrutiny, is currently instrument syncope.18–21