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False positive head-up tilt:

Hemodynamic and neurohumoral profile

Fabio M. Leonelli, MD, FACC^* , Ke Wang, MD^* , Joyce M. Evans, MS , Abhijit R. Patwardhan, PhD , Michael G. Ziegler, MD , Andrea Natale, MD^* , Charles S. Kim, BSE , Kathleen Rajikovich, RN^* and Charles F. Knapp, PhD

^* Department of Cardiology, University of Kentucky, Lexington, Kentucky, USA
Center for Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA
Department of Medicine, University of Kentucky, Lexington, Kentucky, USA
University of San Diego, San Diego, California, USA

View larger version (20K): [in a new window]   Figure 1 Changes in left ventricular end-systolic dimensions (LVESD), left ventricular end-diastolic dimensions (LVEDD), shortening fraction (SF), and rate of change of the same parameters during HUT in the three groups. Throughout the test, end-diastolic, end-systolic dimension, and SF did not change significantly in Group I. In Group II the LVEDD and the SF changed significantly from the baseline values but remained similar to Group I. In Group III all of these parameters changed from baseline; furthermore, the LVEDDs were different from Group I, and the SF was different from both groups. Although LVEDDs were comparable in Group II and Group III, the rate of change in Group III was different from the other two. *p < 0.05 versus Group I. p < 0.05 from baseline. p < 0.05 versus baseline, Group I and II. mm = millimeters; min = minutes; HUT = head-up tilt; before = 1 or 2 min before the end of HUT.

View larger version (37K): [in a new window]   Figure 2 Changes in epinephrine and norepinephrine plasma levels during head-up tilt. The three groups exhibited similar increases in norepinephrine levels during the test. The increase in epinephrine level during HUT was higher in Group III than in the other groups. p < 0.05 versus baseline, Group I and II. HUT = head-up tilt.