The Role of Right Ventricular Contractility in Patients Who Experienced Neurogenic Syncope

Abstract

Introduction: Left ventricular hyper contractility has been thought to have a major role at early phases of vasovagal syncope. However the right ventricular function during syncope has not been delineated clearly. The present study evaluated the right myocardial contractility in patients who experienced vasovagal syncope during head-up tilt test (HUTT).

Patients and Methods: A total of 89 Patients, who experienced syncope between January 2012 and March 2014, were included in the study. All the patients underwent HUTT and were followed by transthoracic echocardiography.

Results: Fifty patients experienced syncope during HUTT. There was no significant difference between the patients, who experienced syncope versus who did not, in terms of gender, age, ejection fraction (p> 0.05). Mitral lateral annular systolic (s’) velocity (14 ± 3.8 vs. 13.3 ± 3.6; p= 0.625), septal annular s’ velocity (11 ± 3.7 vs. 10.3 ± 2; p= 0.951) were similar following HUTT in patients with and without syncope respectively. However, tricuspid valve lateral annular s’ velocity after tilt testing was higher in patients, who experienced syncope (17 ± 2.7 vs. 15.1 ± 3.0; p= 0.003).

Conclusion: While left ventricular functions are not affected, right ventricular contraction is more powerful in patients who experience syncope during HUTT.

Keywords

• Echocardiography,head-up tilt testing,neurogenic syncope

Nörojenik Senkop Geçiren Hastalarda Sağ Ventrikül Kontraksiyonunun Rolü

Abstract

Giriş: Nörojenik senkopun erken safhasında sol ventrikül kontraktilite artışının önemli rolü olduğu düşünülmektedir. Fakat senkop esnasında sağ ventrikül fonksiyonu net olarak ortaya konmamıştır. Bu çalışmada eğik masa testinde (EMT) nörojenik senkop geçiren hastalarda sağ ventrikül fonksiyonu değerlendirilmiştir.

Hastalar ve Yöntem: Ocak 2016 ve Mart 2017 tarihleri arasında senkop geçiren 89 hasta çalışmaya dahil edilmiştir. Tüm hastalara EMT ve ardından transtorasik ekokardiyografi uygulanmıştır.

Bulgular: Eğik masa testinde 50 hastada senkop gelişmiştir. Senkop gelişen ve  gelişmeyen hastalarda cinsiyet, yaş ve ejeksiyon fraksiyonu açısından fark gözlenmemiştir (p>  0.05). Mitral lateral anüler sistolik (s’) velositesi (14 ± 3.8’e karşı 13.3 ± 3.6  p= 0.625), septal anuler s’ velositesi (11 ± 3.7’ye karşı 10.3 ± 2 p= 0.951) senkop gelişen ve gelişmeyen hastalarda benzer izlenmiştir. Fakat senkop geçiren hastalarda triküspit lateral anüler s’ velositesi daha yüksek saptanmıştır (17 ± 2.7’e karşı 15.1 ± 3.0, p= 0.003).

Sonuç: Eğik masa testinde senkop gelişen hastalarda sol ventrikül fonksiyonları değişmezken sağ ventrikül kontraksiyonunda artış gözlenmiştir.

Keywords

• Ekokardiyografi,eğik masa testi,nörojenik senkop

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