Evidence map›Paper›PMID 39821313›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Aetiology and haemodynamic patterns of orthostatic hypotension in a tertiary syncope unit.

Madeleine Johansson, Boriana S Gagaouzova, Ineke A van Rossum, Roland D Thijs, Viktor Hamrefors, J Gert van Dijk, Artur Fedorowski

Abstract read
In one paragraph

Article in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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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

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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

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Haemodynamic uniformity in orthostatic hypotension: questioning the clinical relevance of aetiological subtypes.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 · 2025
    Article
4 · The record

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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

7 authors.

Madeleine JohanssonDepartment of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 214 28 Malmö, Sweden.ORCID 0000-0001-9057-9148
Boriana S GagaouzovaDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands.ORCID 0000-0002-3219-1548
Ineke A van RossumDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands.ORCID 0000-0002-0999-7156
Roland D ThijsDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands.ORCID 0000-0003-1435-8970
Viktor HamreforsDepartment of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 214 28 Malmö, Sweden.ORCID 0000-0002-8475-0866
J Gert van DijkDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands.ORCID 0000-0002-6953-7573
Artur FedorowskiDepartment of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 214 28 Malmö, Sweden.ORCID 0000-0002-5352-6327

Funding

Region Stockholm ALF FoUI 988024Swedish Heart Lung Foundation 20220319
6 · The paper itself

Abstract

aimsOrthostatic hypotension (OH) is an important differential diagnosis in unexplained syncope. Neurogenic OH (nOH) has been postulated to differ from non-neurogenic OH (non-nOH), yet pathophysiological differences are largely unexplored. We aimed to investigate aetiology and tilt table test (TTT)-induced haemodynamic responses in symptomatic OH patients. METHODS AND

resultsWe performed a retrospective study analysing patients referred for unexplained syncope or highly symptomatic orthostatic intolerance with TTT-verified classical OH (cOH). Medical records were analysed for the presumptive aetiology of cOH. Fifty-two patients (mean age 73 ± 9 years, 46% women) with good quality TTT recordings were divided into three groups on clinical grounds: nOH, non-nOH, and mixed OH. The log-ratio (LR) method was applied to compare the decrease in mean arterial pressure (MAPLR) and corresponding contributions of heart rate (HRLR), stroke volume (SVLR), and total peripheral resistance (TPRLR) during the upright phase of TTT. The prevalence of cOH was 12 (23%) nOH, 14 (27%) non-nOH, and 26 (50%) mixed OH. No difference in MAPLR was observed among the three groups during the 4th upright minute of TTT (nOH: -0.10 ± 0.04 vs. non-nOH: -0.07 ± 0.05 and vs. mixed OH: -0.06 ± 0.05, P = 0.10). The contributions of HRLR, SVLR, and TPRLR to the drop in MAPLR did not differ between groups (all P > 0.05).

conclusionOne-half of highly symptomatic OH patients had mixed OH, whereas one-quarter had either pure neurogenic or non-neurogenic OH, respectively. Different forms of OH were indifferentiable based on haemodynamic responses during TTT, questioning the clinical utility of such classification. Larger studies are needed to confirm these findings.

Indexed as

HemodynamicsHypotension, OrthostaticSyncopeAgedAged, 80 and overArterial PressureDiagnosis, DifferentialFemaleHeart RateHumansMaleMiddle AgedPredictive Value of TestsPrevalenceRetrospective StudiesStroke VolumeHaemodynamicsOrthostatic hypotensionPathophysiologyTilt table test

Identifiers

PMID39821313
PMCPMC12056546

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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.