Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes

Table 2

Main clinical variables associated with orthostatic syndromes.

Diagnosis	New Dg	Age; Gender, f/m; BMI	OST	ROS	Baseline	Tilt	Comments
Normal	0	64/38	32	14			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (2), palpitations (3), presyncope (patient believes is going to faint) 0, sense of weakness (3), shortness of breath (1), chest pain (0), excessive sweating (1), fatigue (4). 12 patients experienced dizziness associated with movement of the tilt table that resolved after the tilt table did reach the upright position.
OH-c	34	59/37	12	10			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (0), palpitations (0), presyncope (patient believes is going to faint) 0, sense of weakness (3), shortness of breath (3), chest pain (2), excessive sweating (1), fatigue (11).
OH-u	24	37/23	51	51			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (50), palpitations (33), presyncope (patient believes is going to faint) 37, sense of weakness (41), shortness of breath (14), chest pain (6), excessive sweating (33), fatigue (48).
OCHOs	97	59/38	97	95			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (93), palpitations (12), presyncope (patient believes is going to faint) 44, sense of weakness (34), shortness of breath (6), chest pain (9), excessive sweating (22), fatigue (67).
OHTN	14	3/11	13	13			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (4), palpitations (0), presyncope (patient believes is going to faint) 4, sense of weakness (10), shortness of breath (4), chest pain (3), excessive sweating (1), fatigue (12).
POTS	67	86/15	100	100			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (82), palpitations (80), presyncope (patient believes is going to faint) 62, sense of weakness (72), shortness of breath (30), chest pain (31), excessive sweating (18), fatigue (34). HR during the tilt is the average of maximal values of each subject.
IST	24	22/6	24	24			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (21), palpitations (24), presyncope (patient believes is going to faint) 12, sense of weakness (15), shortness of breath (18), chest pain (9), excessive sweating (8), fatigue (18).
PST	12	10/2	12	12			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (3), palpitations (12), presyncope (patient believes is going to faint) 2, sense of weakness (5), shortness of breath (7), chest pain (1), excessive sweating (2), fatigue (10). HR during the tilt is the average of maximal values of each subject.
Syncope-cardioinhibitory	3	3/1	4	3			Loss of consciousness (4), additional orthostatic symptoms during the tilt test: dizziness or lightheadedness (3), palpitations (0), presyncope (patient believes is going to faint) 4, sense of weakness (3), shortness of breath (4), chest pain (0), excessive sweating (2), fatigue (1). Tilt vitals obtained during syncope.
Syncope-vasodepressor	11	7/5	12	2			Loss of consciousness (12); additional orthostatic symptoms during the tilt test: dizziness or lightheadedness (11), palpitations (7), presyncope (patient believes is going to faint) 8, sense of weakness (8), shortness of breath (9), chest pain (1), excessive sweating (7), fatigue (4). Tilt vitals obtained during syncope.
Syncope-mixed	10	14/12	26	12			Loss of consciousness (26); additional orthostatic symptoms during the tilt test: loss of consciousness (22), dizziness or lightheadedness (21), palpitations (14), presyncope (patient believes is going to faint) 22, sense of weakness (25), shortness of breath (17), chest pain (2), excessive sweating (21), fatigue (19). Tilt vitals obtained during syncope.
pCAF	67	31/36	22	22			Orthostatic symptoms during the tilt test: dizziness or lightheadedness (61), palpitations (10), presyncope (patient believes is going to faint) 33, sense of weakness (45), shortness of breath (17), chest pain (12), excessive sweating (21), fatigue (50). All patients had also prominent nonpositional symptoms including chronic fatigue (33), weakness (32), forgetfulness (45), and attention deficit (54).
Psychogenic pseudosyncope	3	7/1	8	8			Loss of consciousness (8); additional orthostatic symptoms during the tilt test: dizziness or lightheadedness (6), palpitations (4), presyncope (patient believes is going to faint) 2, sense of weakness (4), shortness of breath (5), chest pain (1), excessive sweating (2), fatigue (5), eye flutter (4), moaning (4), bizarre posturing (4). Tilt vitals obtained during pseudosyncope.

Comments: diagnosis = diagnosis obtained during the tilt test; new Dg = diagnosis obtained from the tilt test that is different from the referral diagnosis or it is not documented in the chart (e.g., if the patient was referred for evaluation of orthostatic hypotension and the tilt test showed POTS); = number of subjects; OST = orthostatic symptoms during the tilt, the number of subjects with at least one orthostatic symptom; ROS = reproduction of previous orthostatic symptoms (e.g., the symptoms that prompted the autonomic testing) during the tilt; OH = orthostatic hypotension; OH-compensated = OH with normal orthostatic CBFv; OH-uncompensated = OH with reduced orthostatic CBFv; OCHOs = orthostatic cerebral hypoperfusion syndrome; OHTN = orthostatic hypertension syndrome; POTS = postural tachycardia syndrome; IST = inappropriate sinus tachycardia; PST = paroxysmal sinus tachycardia; pCAF = primary cerebral autoregulatory failure; BMI = body mass index (kg/m²); CBFv = cerebral blood flow velocity (cm/s); HR = heart rate (beats per minute), BP = blood pressure (mmHg); Q-LF = QASAT supine low CBFv score, Q-TF = QASAT CBFv during the tilt score. All variables expressed as mean ± sd if not described otherwise; elevated compared to normals; reduced compared to normal response to the tilt.