Evidence map›Paper›PMID 33624801›Full record

ArticleEuropean heart journal2021

Tilt testing remains a valuable asset.

Richard Sutton, Artur Fedorowski, Brian Olshansky, J Gert van Dijk, Haruhiko Abe, Michele Brignole, Frederik de Lange, Rose Anne Kenny, Phang Boon Lim, Angel Moya and 5 more

Open access · hybridAbstract read
In one paragraph

Article in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 1 pooled it
14.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.

  1. Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Guideline
  2. Review
  3. Review
  4. Article
  5. Sensor detection and pacing for impending reflex syncope.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Review
  6. Article
  7. Review
  8. Article
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  10. Article
  11. Article
  12. Article
  13. Carotid sinus massage in clinical practice: the Six-Step-Method.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
  14. Article
  15. Review
  16. Asystole on loop recorder in patients with unexplained syncope and negative tilt testing: age distribution and clinical predictors.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024
    Article
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  18. Article
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 14 institutions in 8 countries.

Richard SuttonDepartment of Cardiology, Imperial College, London, UK.ORCID 0000-0002-5710-1094
Artur FedorowskiDepartment of Cardiology, Skåne University Hospital and Lund University, Malmö, Sweden.ORCID 0000-0002-5352-6327
Brian OlshanskyDepartment of Cardiology, University of Iowa, Iowa City, IA, USA.ORCID 0000-0002-6044-045X
J Gert van DijkDepartment of Neurology, Leiden University Medical Centre, The Netherlands.
Haruhiko AbeDepartment of Heart Rhythm Management, University of Occupational and Environmental Health, Kitakyushu, Japan.
Michele BrignoleIstituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Milano, Italy.ORCID 0000-0002-1845-5607
Frederik de LangeDepartment of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands.ORCID 0000-0002-7590-9230
Rose Anne KennySchool of Medicine, Trinity College, Dublin, Ireland.
Phang Boon LimDepartment of Cardiology, Hammersmith Hospital, Imperial College, London, UK.
Angel MoyaDepartment of Cardiology, Dexeus University Hospital, Barcelona, Spain.
Stuart D RosenNational Heart & Lung Institute, Royal Brompton Hospital, Imperial College, London, UK.
Vincenzo RussoDepartment of Translational Sciences, University of Campania, Naples, Italy.
Julian M StewartDepartment of Pediatrics, New York Medical College, Valhalla, NY, USA.ORCID 0000-0002-6082-359X
Roland D ThijsDepartment of Neurology, Leiden University Medical Centre, The Netherlands.ORCID 0000-0003-1435-8970
David G BendittCardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA.
Leiden University Medical Center · NLAmsterdam Neuroscience · NLHeart Rhythm Society · USHospital Universitario Dexeus · ESImperial College London · GBIRCCS Istituto Auxologico Italiano · ITLondon Clinic · GBLund University · SENew York Medical College · USRoyal Brompton Hospital · GBTrinity College Dublin · IEUniversity of Campania "Luigi Vanvitelli" · ITUniversity of Iowa · USUniversity of Minnesota · US

Funding

Cardiovagal baroreflex deficits impair neurovascular coupling and cognition in Postural Tachycardia SyndromeR01HL134674 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2017 to 2020
$2.5M
Mechanisms of Vasovagal SyncopeR01HL112736 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2013 to 2016
$2.1M
NHLBI NIH HHS R01 HL112736NHLBI NIH HHS R01 HL134674
6 · The paper itself

Abstract

Head-up tilt test (TT) has been used for >50 years to study heart rate/blood pressure adaptation to positional changes, to model responses to haemorrhage, to assess orthostatic hypotension, and to evaluate haemodynamic and neuroendocrine responses in congestive heart failure, autonomic dysfunction, and hypertension. During these studies, some subjects experienced syncope due to vasovagal reflex. As a result, tilt testing was incorporated into clinical assessment of syncope when the origin was unknown. Subsequently, clinical experience supports the diagnostic value of TT. This is highlighted in evidence-based professional practice guidelines, which provide advice for TT methodology and interpretation, while concurrently identifying its limitations. Thus, TT remains a valuable clinical asset, one that has added importantly to the appreciation of pathophysiology of syncope/collapse and, thereby, has improved care of syncopal patients.

Indexed as

Autonomic Nervous System DiseasesHypotension, OrthostaticHeart RateHumansSyncopeTilt-Table TestActive standECG-loop recordersOrthostatic hypotensionPostural orthostatic tachycardia syndromePsychogenic pseudosyncopeSyncopeTilt-table testVasovagal syncope

Identifiers

PMID33624801
PMCPMC8245144
OpenAlexW3131364904

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.