Objectives: The aim of study was an analysis of baroreceptor sensitivity Changes of baroreceptor sensitivity during the treatment of with vasovagal syncope with tilt training.
Study population: we observed 75 pts. (23 men, 1162 women) aged 18-42 yrs (median of age: 21 yrs) with vasovagal syncope (VVS) confirmed by head-up tilt test (HUTT) and referred to non-pharmacological treatment by tilt training.
Methods: All pts underwent HUTT performed according Italian protocol. After positive HUTT result patient were referred to classical tilt training proposed by Ector – repeated tilting until achieving two consecutive negative responses. Continuous non-invasive monitoring of heart rate (HR) and blood pressure (beat-to beat) was performed using NEXFIN analyser. Based on registered HR and blood pressure values the baroreceptor sensitivity index (iBRS) was calculated separately for supine and for tilting during the following training sessions.
Results: Significant reduction of iBRS during tilt across the training cycle was observed in all patients (2,5 vs. 9,8 ms/mmHg p<0,01), whereas there was no changes regarding supine values of iBRS through the training.
Conclusions: 1. Modification of baroreceptor sensitivity during the tilting seems to be important mechanism responsible for antysyncopal effect of tilt training. 2. The monitoring of tilt related baroreceptor sensitivity may be marker of effectiveness of treatment of vasovagal syncope by tilt training .