Evidence map›Paper›PMID 34504263›Full record

ArticleScientific reports2021

Underlying hemodynamic differences are associated with responses to tilt testing.

Artur Fedorowski, Giulia Rivasi, Parisa Torabi, Madeleine Johansson, Martina Rafanelli, Irene Marozzi, Alice Ceccofiglio, Niccolò Casini, Viktor Hamrefors, Andrea Ungar and 4 more

Open access · goldAbstract read
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 13% 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

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Vasovagal syncope: the role of 24 h ambulatory blood pressure monitoring.European heart journal supplements : journal of the European Society of Cardiology · 2026
    Article
  2. Diagnostic yield of nitroglycerin-potentiated head-up tilt test in a pediatric population with suspected reflex syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025
    Article
  3. Article
  4. Variability of cardioinhibition in vasovagal syncope: differences between subgroups during cardioinhibition and beyond.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023
    Article
  5. Twenty-five years of research on 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 · 2023
    Article
  6. Observational
  7. Lifetime prevalence and correlates of syncope in five ancestry groups. The HELIUS study.International journal of cardiology. Heart & vasculature · 2022
    Article
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

14 authors at 6 institutions in 4 countries.

Artur FedorowskiDepartment of Clinical Sciences, Lund University, Malmö, Sweden. artur.fedorowski@med.lu.se.
Giulia RivasiSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Parisa TorabiDepartment of Clinical Sciences, Lund University, Malmö, Sweden.
Madeleine JohanssonDepartment of Clinical Sciences, Lund University, Malmö, Sweden.
Martina RafanelliSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Irene MarozziSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Alice CeccofiglioSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Niccolò CasiniSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Viktor HamreforsDepartment of Clinical Sciences, Lund University, Malmö, Sweden.
Andrea UngarSyncope Unit, Division of Geriatrics and Intensive Care Unit, Careggi Hospital, University of Florence, Florence, Italy.
Brian OlshanskyDivision of Cardiology, Department of Internal Medicine, University of Iowa Hospitals, Iowa City, IA, USA.
Richard SuttonDepartment of Cardiology, Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28, Malmö, Sweden.
Michele BrignoleFaint & Fall Programme, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy.
Gianfranco ParatiFaint & Fall Programme, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano, Italy.
University of Florence · ITLund University · SEHammersmith Hospital · GBIRCCS Istituto Auxologico Italiano · ITPresidio Ospedaliero · ITUniversity of Iowa Hospitals and Clinics · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim of this study was to explore whether differences in resting hemodynamic parameters may be associated with tilt test results in unexplained syncope. We analyzed age, gender, systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) by merging three large databases of patients considered likely to be of vasovagal reflex etiology, comparing patients who had tilt-induced reflex response with those who did not. Tilt-induced reflex response was defined as spontaneous symptom reproduction with characteristic hypotension and bradycardia. Relationship of demographics and baseline supine BP to tilt-test were assessed using logistic regression models. Individual records of 5236 patients (45% males; mean age: 60 ± 22 years; 32% prescribed antihypertensive therapy) were analyzed. Tilt-positive (n = 3129, 60%) vs tilt-negative patients had lower SBP (127.2 ± 17.9 vs 129.7 ± 18.0 mmHg, p < 0.001), DBP (76.2 ± 11.5 vs 77.7 ± 11.7 mmHg, p < 0.001) and HR (68.0 ± 11.5 vs 70.5 ± 12.5 bpm, p < 0.001). In multivariable analyses, tilt-test positivity was independently associated with younger age (Odds ratio (OR) per 10 years:1.04; 95% confidence interval (CI), 1.01-1.07, p = 0.014), SBP ≤ 128 mmHg (OR:1.27; 95%CI, 1.11-1.44, p < 0.001), HR ≤ 69 bpm (OR:1.32; 95%CI, 1.17-1.50, p < 0.001), and absence of hypertension (OR:1.58; 95%CI, 1.38-1.81, p < 0.001). In conclusion, among patients with suspected reflex syncope, younger age, lower blood pressure and lower heart rate are associated with positive tilt-test result.

Indexed as

AdolescentAdultAgedAged, 80 and overBlood PressureBradycardiaChildFemaleHeart RateHemodynamicsHumansHypotensionMaleMiddle AgedSyncope, VasovagalTilt-Table Test

Identifiers

PMID34504263
PMCPMC8429732
OpenAlexW3196937832

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.