SHORT DURATION HEAD-UP TILT TEST: A COMPARISON WITH CONVENTIONAL LONG PROTOCOL IN PATIENTS OF ORTHOSTATIC INTOLERANCE
AbstractBackground: Orthostatic intolerance is development of symptoms during upright standing relieved byrecumbency. An individual’s predisposition to orthostatic intolerance (development of symptomsduring upright posture) can be identified by Head-up Tilt Test (HUT). The aim of the present study wasto compare the diagnostic yield (Percentage of patients tested positive) of short duration withconventional HUT. Methods: The study was conducted in Islamic International Medical College,Rawalpindi in collaboration with Armed Forces Institute of Cardiology/National Institute of HeartDiseases. A total number of 100 patients with orthostatic intolerance were studied. The conventionaland short duration HUT protocols were compared. Conventional protocol had a passive tilt phase of 30minutes and drug provocation phase of 20 minutes while the short duration protocol had both phases of15 minutes, thereby reducing the test duration by 20 minutes. All patients underwent short durationHUT and patients with positive test were considered positive for conventional HUT as well. Patientshaving negative short duration HUT underwent conventional HUT after one week. Comparison wasdone using Chi-square statistics and p<0.05 was considered significant. Results: Diagnostic yield ofshort duration and conventional HUT was 53% and 63% respectively with no statistically significantdifference between the two protocols (p=0.15). Conclusions: Head-up tilt test (HUT) is an effectiveinvestigative tool for orthostatic intolerance with satisfactory diagnostic yield. Short duration HUT maybe substituted for conventional HUT to save time and to accommodate more patients.Keywords: Orthostatic intolerance, Head-up tilt test, Nitroglycerine
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