Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome
Background. Head-up tilt testing (HUTT), a well-established tool in the diagnosis of vasovagal syncope, is time-consuming, and every provoked vasovagal reaction may result in consolidating the reflex mechanism. Therefore, identification of parameters that could shorten the duration of HUTT and preve...
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2021-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/8882498 |
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| author | Paweł Krzesiński Jacek Marczyk Bartosz Wolszczak Grzegorz Gielerak |
| author_facet | Paweł Krzesiński Jacek Marczyk Bartosz Wolszczak Grzegorz Gielerak |
| author_sort | Paweł Krzesiński |
| collection | DOAJ |
| description | Background. Head-up tilt testing (HUTT), a well-established tool in the diagnosis of vasovagal syncope, is time-consuming, and every provoked vasovagal reaction may result in consolidating the reflex mechanism. Therefore, identification of parameters that could shorten the duration of HUTT and prevent fainting is desirable. Quantitative complexity theory (QCT) may provide holistic information on the cardiovascular reaction in HUTT. The aim of the present article was to evaluate the prognostic value of complexity in comparison with traditional haemodynamic parameters (HR and BP) in predicting the HUTT outcome. Methods. Eighty-one healthy volunteers (74 men; mean age: 37.8 years) were included in this retrospective analysis of data collected within the project realized in Department of Cardiology and Internal Diseases, Military Institute of Medicine between January 2012 and October 2014. The subjects underwent HUTT, with beat-to-beat haemodynamic monitoring with a Niccomo™. The chosen haemodynamic parameters (including BP, HR, stroke volume, cardiac output, systemic vascular resistance) have been used in complexity analysis. Results. HUTT was positive in 54 (66.7%) study participants. The values of complexity were already higher in fainting subjects than those were in nonfainting ones 300 s before HUTT termination (HUTT_end), with a significant upward trend starting 150 s before (pre)syncope. An area under the curve (AUC) over 0.700 was observed for complexity from 120 s before HUTT_end, with a sensitivity of 63% and specificity of 78% at this time point. The prognostic value of complexity was superior to that of the HR and mean arterial pressure (MAP). Conclusions. Complexity has been shown to be a sensitive marker of cardiovascular haemodynamic response to orthostatic stress and proved to be superior over HR and BP in predicting HUTT outcomes. |
| format | Article |
| id | doaj-art-44aa296c85a14ddfa2ca74f7dc1476e2 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-44aa296c85a14ddfa2ca74f7dc1476e22025-02-03T01:24:41ZengWileyCardiology Research and Practice2090-80162090-05972021-01-01202110.1155/2021/88824988882498Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing OutcomePaweł Krzesiński0Jacek Marczyk1Bartosz Wolszczak2Grzegorz Gielerak3Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, Warsaw 04-141, PolandOntonix S.r.l., Via Campo Garibaldi 1, Como 22100, ItalyOntonix S.r.l., Via Campo Garibaldi 1, Como 22100, ItalyDepartment of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, Warsaw 04-141, PolandBackground. Head-up tilt testing (HUTT), a well-established tool in the diagnosis of vasovagal syncope, is time-consuming, and every provoked vasovagal reaction may result in consolidating the reflex mechanism. Therefore, identification of parameters that could shorten the duration of HUTT and prevent fainting is desirable. Quantitative complexity theory (QCT) may provide holistic information on the cardiovascular reaction in HUTT. The aim of the present article was to evaluate the prognostic value of complexity in comparison with traditional haemodynamic parameters (HR and BP) in predicting the HUTT outcome. Methods. Eighty-one healthy volunteers (74 men; mean age: 37.8 years) were included in this retrospective analysis of data collected within the project realized in Department of Cardiology and Internal Diseases, Military Institute of Medicine between January 2012 and October 2014. The subjects underwent HUTT, with beat-to-beat haemodynamic monitoring with a Niccomo™. The chosen haemodynamic parameters (including BP, HR, stroke volume, cardiac output, systemic vascular resistance) have been used in complexity analysis. Results. HUTT was positive in 54 (66.7%) study participants. The values of complexity were already higher in fainting subjects than those were in nonfainting ones 300 s before HUTT termination (HUTT_end), with a significant upward trend starting 150 s before (pre)syncope. An area under the curve (AUC) over 0.700 was observed for complexity from 120 s before HUTT_end, with a sensitivity of 63% and specificity of 78% at this time point. The prognostic value of complexity was superior to that of the HR and mean arterial pressure (MAP). Conclusions. Complexity has been shown to be a sensitive marker of cardiovascular haemodynamic response to orthostatic stress and proved to be superior over HR and BP in predicting HUTT outcomes.http://dx.doi.org/10.1155/2021/8882498 |
| spellingShingle | Paweł Krzesiński Jacek Marczyk Bartosz Wolszczak Grzegorz Gielerak Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome Cardiology Research and Practice |
| title | Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome |
| title_full | Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome |
| title_fullStr | Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome |
| title_full_unstemmed | Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome |
| title_short | Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome |
| title_sort | quantitative complexity theory used in the prediction of head up tilt testing outcome |
| url | http://dx.doi.org/10.1155/2021/8882498 |
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