Indian heart journal最新文献

{"title":"Fragmented QRS complex as a predictor of in-hospital life-threatening arrhythmias in myocardial infarction patients: A systematic review and meta-analysis","authors":"Tanawat Attachaipanich ,&nbsp;Suthinee Attachaipanich ,&nbsp;Kotchakorn Kaewboot","doi":"10.1016/j.ihj.2025.04.003","DOIUrl":"10.1016/j.ihj.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular arrhythmia is an important cause of death in myocardial infarction (MI). Fragmented QRS (fQRS) is an ECG pattern reflecting the inhomogeneity of ventricular conduction and has been demonstrated to be a predictor of arrhythmia in several cardiac conditions. This study aimed to evaluate the prognostic impact of fQRS on arrhythmias in MI patients.</div></div><div><h3>Methods</h3><div>A systematic search was conducted using 4 databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to July 20, 2024. The inclusion criteria were studies that included MI patients and compared the rate of in-hospital arrhythmia between fQRS and non-fQRS participants.</div></div><div><h3>Results</h3><div>A total of 14 studies were included in this meta-analysis, involving 4566 participants. The presence of fQRS was associated with a higher incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) compared to non-fQRS, with an odds ratio (OR) of 2.96 (95 %CI 2.00 to 4.39), <em>p</em> &lt; 0.01. Similarly, fQRS was associated with a higher risk of VT, with an OR of 3.59 (95 %CI 1.66 to 7.80), <em>p</em> &lt; 0.01. Although the presence of fQRS did not significantly increase the risk of VF compared to non-fQRS, a sensitivity analysis that excluded a study with serious risk of bias showed that the presence of fQRS was associated with an increased risk of VF, with an OR of 2.45 (95 %CI 1.38 to 4.35), <em>p</em> &lt; 0.01.</div></div><div><h3>Conclusions</h3><div>The presence of fQRS was associated with a higher risk of in-hospital arrhythmia in MI patients. The fQRS is a potential tool for risk stratification in MI patients for arrhythmia.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 142-150"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous device closure for Paravalvular leak- A single centre experience","authors":"Uday B. Khanolkar,&nbsp;Meemansa Kashyap Buch,&nbsp;Satish C. Govind,&nbsp;Barendra Kumar Raut,&nbsp;Bagirath Raghuraman,&nbsp;Kapil Kumawat,&nbsp;Bijay Kumar Mahala,&nbsp;Arjun Shenoi,&nbsp;Devi Prasad Shetty","doi":"10.1016/j.ihj.2025.02.008","DOIUrl":"10.1016/j.ihj.2025.02.008","url":null,"abstract":"<div><div>The incidence of paravalvular leak (PVL) following surgical valve replacement is 5–17%. Our main aim is to determine the safety and efficacy of percutaneous device closure for significant PVLs.Transcatheter device closure was done for 45 PVLs in 42 patients. PVLs were closed percutaneously in mitral position in 23 cases, in aortic position in 20 cases, and combined mitral and aortic leaks in 2 cases. We achieved a technical success rate of 93.33 % and procedural success rate of 91.11%. Transcatheter PVL closure is a safe and effective procedure for symptomatic PVLs.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 235-242"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes of rotational atherectomy in patients with reduced left ventricular ejection fraction: A retrospective review from a tertiary referral centre","authors":"Kewal Kanabar ,&nbsp;Pooja Vyas ,&nbsp;Krutika Patel ,&nbsp;Gourav Behra","doi":"10.1016/j.ihj.2025.03.017","DOIUrl":"10.1016/j.ihj.2025.03.017","url":null,"abstract":"<div><h3>Objective</h3><div>Rotational atherectomy (RA), a commonly used technique for the percutaneous intervention of calcific coronary lesions, produces micro-debris which cause downstream microvascular obstruction, slow flow, and myocardial stunning leading to adverse outcomes in patients with left ventricular (LV) systolic dysfunction. Hence, the presence of LV dysfunction was considered a relative contraindication for RA. We aimed to assess the safety of RA in patients with LV dysfunction.</div></div><div><h3>Method</h3><div>This is a retrospective review of all consecutive patients who underwent RA at our tertiary referral centre over a 6-year period (2018–2023). All medical records, procedural details, and in-hospital outcomes were recorded. The primary outcome of the study was in-hospital mortality.</div></div><div><h3>Results</h3><div>504 patients who underwent RA during the study duration were divided into two groups: Group 1 (<em>n</em> = 209) with left ventricular ejection fraction (LVEF) ≤35 % (mean 29.14 ± 4.95 %) and group 2 (<em>n</em> = 295) with moderately reduced or preserved LVEF &gt;35 % (mean 47.86 ± 6.68 %). There was no significant difference in the baseline demographic characteristics, risk factors, angiographic profile, stent length, contrast volume, and procedure time between the two groups. The in-hospital mortality was not different between the two groups (2.3 % vs 0.7 % <em>p</em> = 0.63). LVEF was not found to be an independent predictor of mortality in patients undergoing RA.</div></div><div><h3>Conclusion</h3><div>The in-hospital mortality of patients undergoing PCI with RA was not affected by the presence of LV dysfunction. Additional studies with a longer follow-up duration and a larger sample or a meta-analysis incorporating our study are needed to confirm these results.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 170-173"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic testing of cardiomyopathies: Position statement of the Cardiological Society of India","authors":"Ajay Bahl ,&nbsp;Sandeep Seth ,&nbsp;Perundurai S. Dhandapany ,&nbsp;Anupam Mittal ,&nbsp;Priya Chockalingam ,&nbsp;Hisham Ahamed ,&nbsp;Muthiah Subramanian ,&nbsp;Sheela Nampoothiri ,&nbsp;Narayanan Namboodiri ,&nbsp;Soumi Das ,&nbsp;Vanya Vaidya ,&nbsp;Rajaram Anantharaman ,&nbsp;Madhu Khullar ,&nbsp;Deepa Selvi Rani ,&nbsp;Kumarasamy Thangaraj ,&nbsp;Nitish Naik ,&nbsp;Sridhar Sivasubbu ,&nbsp;Debabrata Roy ,&nbsp;Vijay Harikisan Bang ,&nbsp;Partha Sarathi Banerjee ,&nbsp;Dipankar Ghosh Dastidar","doi":"10.1016/j.ihj.2025.03.013","DOIUrl":"10.1016/j.ihj.2025.03.013","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 213-230"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging ECG images for predicting ejection fraction using machine learning algorithms","authors":"Abhyuday Kumara Swamy ,&nbsp;Vivek Rajagopal ,&nbsp;Deepak Krishnan ,&nbsp;Paramita Auddya Ghorai ,&nbsp;Anagha Choukhande ,&nbsp;Santhosh Rathnam Palani ,&nbsp;Deepak Padmanabhan ,&nbsp;Emmanuel Rupert ,&nbsp;Devi Prasad Shetty ,&nbsp;Pradeep Narayan","doi":"10.1016/j.ihj.2025.03.009","DOIUrl":"10.1016/j.ihj.2025.03.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The capability to accurately predict the ejection fraction (EF) from an electrocardiogram (ECG) holds significant and valuable clinical implications. Various algorithms based on ECG images are currently being evaluated, with most methods requiring raw signal data from ECG devices. In this study, our objective was to train and validate a neural network on a readily available ECG trace image graph to determine the presence or absence of left ventricular dysfunction (LVD).</div></div><div><h3>Methods</h3><div>12-lead ECG trace images paired with their echocardiogram reports performed on the same day were selected. A DenseNet121 model, using ECG images as input, was trained to identify EF &lt;50 %. and then externally validated.</div></div><div><h3>Results</h3><div>1,19,281 ECG-echocardiogram pairs were used for model development. The model demonstrated comparable performance in both the internal test data and external validation data. The area under receiver operating characteristic and precision–recall curves were 0.92 and 0.78, respectively, for the internal test data and 0.88 and 0.74, respectively, for the external validation data. The model accurately identified more than 85 % of cases with EF &lt;50 % in both datasets.</div></div><div><h3>Conclusions</h3><div>Actual images of ECGs with simple pre-processing and model architecture can be used as a reliable tool to screen for LVD. The use of images expands the reach of these algorithms to geographies with resource and technological limitations.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 182-187"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of machine learning models versus TIMI score in ST-segment-elevation myocardial infarction patients","authors":"Mohit D. Gupta ,&nbsp;Dixit Goyal ,&nbsp;Shekhar Kunal ,&nbsp;Manu Kumar Shetty ,&nbsp;M.P. Girish ,&nbsp;Vishal Batra ,&nbsp;Ankit Bansal ,&nbsp;Prashant Mishra ,&nbsp;Mansavi Shukla ,&nbsp;Vanshika Kohli ,&nbsp;Akul Chadha ,&nbsp;Arisha Fatima ,&nbsp;Subrat Muduli ,&nbsp;Anubha Gupta ,&nbsp;Jamal Yusuf","doi":"10.1016/j.ihj.2025.03.010","DOIUrl":"10.1016/j.ihj.2025.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Risk stratification is an integral component of ST-segment-elevation myocardial infarction (STEMI) management practices. This study aimed to derive a machine learning (ML) model for risk stratification and identification of factors associated with in-hospital and 30-day mortality in patients with STEMI and compare it with traditional TIMI score.</div></div><div><h3>Methods</h3><div>This was a single center prospective study wherein subjects &gt;18 years with STEMI (<em>n</em> = 1700) were enrolled. Patients were divided into two groups: training (<em>n</em> = 1360) and validation dataset (<em>n</em> = 340). Six ML algorithms (Extra Tree, Random Forest, Multiple Perceptron, CatBoost, Logistic Regression and XGBoost) were used to train and tune the ML model and to determine the predictors of worse outcomes using feature selection. Additionally, the performance of ML models both for in-hospital and 30-day outcomes was compared to that of TIMI score.</div></div><div><h3>Results</h3><div>Of the 1700 patients, 168 (9.88 %) had in-hospital mortality while 30-day mortality was reported in 210 (12.35 %) subjects. In terms of in-hospital mortality, Random Forest ML model (sensitivity: 80 %; specificity: 74 %; AUC: 80.83 %) outperformed the TIMI score (sensitivity: 70 %; specificity: 64 %; AUC:70.7 %). Similarly, Random Forest ML model (sensitivity: 81.63 %; specificity: 78.35 %; AUC: 78.29 %) had better performance as compared to TIMI score (sensitivity: 63.26 %; specificity: 63.91 %; AUC: 63.59 %) for 30-day mortality. Key predictors for worse outcomes at 30-days included mitral regurgitation on presentation, smoking, cardiogenic shock, diabetes, ventricular septal rupture, Killip class, age, female gender, low blood pressure and low ejection fraction.</div></div><div><h3>Conclusions</h3><div>ML model outperformed the traditional regression based TIMI score as a risk stratification tool in patients with STEMI.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 133-141"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risk factors of low cardiac output syndrome after pericardiectomy for tuberculous constrictive pericarditis: A retrospective study","authors":"Shuangshuang Yan ,&nbsp;Jing Guo ,&nbsp;Shuzhen Wang ,&nbsp;Lijuan Zhang ,&nbsp;Li Zhang ,&nbsp;Qiuyu Xiao ,&nbsp;Qian Li ,&nbsp;Zhengkai Zhao ,&nbsp;Lijian Cheng ,&nbsp;Feng Xiong","doi":"10.1016/j.ihj.2025.05.006","DOIUrl":"10.1016/j.ihj.2025.05.006","url":null,"abstract":"<div><h3>Objective</h3><div>Low cardiac output syndrome (LCOS) is the leading cause of death after cardiac surgery. Studies have shown that 24% of postoperative mortality in patients undergoing pericardiectomy is attributed to LCOS. It is necessary to explore the risk factors of LCOS after pericardiectomy in patients with tuberculous constrictive pericarditis (CP).</div></div><div><h3>Methods</h3><div>Patients undergoing pericardiectomy for tuberculous CP were included in the study. The personal and clinical data of these patients with LCOS and without LCOS were collected and compared. Logistic regression analyses were conducted to identify the risk factors of postoperative LCOS. ROC curve analysis was used to check the accuracy of each risk factor to predict LCOS.</div></div><div><h3>Results</h3><div>A total of 175 patients with tuberculous CP were included in this study, of which 35 cases developed LCOS postoperatively, resulting in an incidence rate of 20%. The independent predictors of LCOS were preoperative NYHA class III/IV, decreased left ventricular mass index (LVMI), and hypoalbuminemia in these patients (<em>p</em> &lt; 0.05). When albumin (ALB) &lt; 30.35 g/L, it had the highest diagnostic value in predicting postoperative LCOS, with sensitivity and specificity of 59.4% and 86.9%, respectively (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>For patients with tuberculous CP, preoperative NYHA class III/IV, lower LVMI, and hypoalbuminemia are independent risk factors for LCOS following pericardiectomy. Clinically, these risk factors should be identified as early as possible, and early pericardiectomy should be performed when the patient's cardiac function remains well-preserved to avoid the occurrence of cardiac cachexia, myocardial atrophy and severe hepatic insufficiency.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 164-169"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and long-term outcomes of drug coated balloon in de novo lesions of small versus large coronary vessels","authors":"Hesham Refaat,&nbsp;Mohamed Arab","doi":"10.1016/j.ihj.2025.03.015","DOIUrl":"10.1016/j.ihj.2025.03.015","url":null,"abstract":"<div><h3>Objective</h3><div>Drug eluting stent (DES) could result in both in-stent restenosis and high bleeding risk due to long-term anti-platelet therapy. Drug-coated balloon (DCB) delivers anti-proliferative drugs without implanting metal into vascular wall. Our aim was to investigate its feasibility in large vessel coronary artery disease (LvCAD), compared to small vessel coronary artery disease (SvCAD).</div></div><div><h3>Methods</h3><div>This study enrolled 237 patients with de novo coronary lesions treated with DCB-only strategy and categorized according to the reference vessel diameter of 3 mm into SvCAD and LvCAD groups. The primary endpoint was in-lesion late lumen loss (LLL). The secondary endpoints included composite major adverse cardiac events (MACE), cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and vessel thrombosis.</div></div><div><h3>Results</h3><div>The immediate (3.06 ± 0.25 vs. 2.33 ± 0.21 mm, <em>p</em> = 0.001) and follow up minimal lumen diameter (3.13 ± 0.25 vs. 2.41 ± 0.21 mm, <em>p</em> = 0.001) and acute gain (1.92 ± 0.29 vs. 1.5 ± 0.26 mm, <em>p</em> = 0.04) were significantly higher in LvCAD group. In-lesion LLL was negative without significant difference (-0.07 ± 0.02 vs. - 0.06 ± 0.04 mm, <em>p</em> = 0.69). The incidence of adverse clinical events was not statistically significant accounting for 6.5 % vs. 10.5 % for composite MACE (<em>p</em> = 0.27), 0.8 % vs. 0.9 % for cardiac death (<em>p</em> = 0.96), 4.9 % vs.7 % for non-fatal MI (<em>p</em> = 0.49), 4.1 % vs. 6.1 % for TLR (<em>p</em> = 0.47), 2.4 % vs. 3.5 % for TVR (<em>p</em> = 0.63) and 1.6 % vs. 2.6 % for vessel thrombosis (<em>p</em> = 0.59).</div></div><div><h3>Conclusion</h3><div>DCB-only strategy is effective in treating LvCAD with comparable outcomes to SvCAD.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 174-181"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac evaluation in patients awaiting kidney transplant-position statement of the Cardiological Society of India and Indian Society of Nephrology","authors":"Ajay Bahl ,&nbsp;Narayan Prasad ,&nbsp;Dhurjati Prasad Sinha ,&nbsp;Kajal Ganguly ,&nbsp;Sandipta Roy ,&nbsp;Debabrata Roy ,&nbsp;Sumit Rakshit ,&nbsp;Dilip Kumar ,&nbsp;Saurav Das ,&nbsp;Dinkar Bhasin ,&nbsp;Sree Bhushan Raju ,&nbsp;Mayuri Trivedi ,&nbsp;Manish Rathi ,&nbsp;Sanjeev Gulati ,&nbsp;Sourabh Agstam ,&nbsp;Vinant Bhargava ,&nbsp;Anil Kumar Bhalla ,&nbsp;Shyam Bihari Bansal ,&nbsp;Santosh Varughese ,&nbsp;Manas Ranjan Patel ,&nbsp;Partha Sarathi Banerjee","doi":"10.1016/j.ihj.2025.03.012","DOIUrl":"10.1016/j.ihj.2025.03.012","url":null,"abstract":"<div><div>Cardiovascular diseases are a major cause of death after kidney transplantation. This statement addresses preoperative cardiac decision-making and management with the aim of assessing and reducing the risk of the kidney transplant surgery. Important issues from a clinician's perspective include the basic cardiovascular workup of these patients, coronary evaluation and management of coronary artery disease, valvular heart disease and left ventricular systolic dysfunction. Recovery left ventricular function after kidney transplant is discussed. In addition, the use of cardiovascular drugs in patients with special emphasis on antiplatelets and anticoagulants in patients planned for kidney transplant is also discussed.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 204-212"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A contemporary review of the head-up tilt test: Utility and limitations","authors":"Ameya Udyavar ,&nbsp;Jayaprakash Shenthar ,&nbsp;Ajay Madhukar Naik ,&nbsp;Dibbendhu Khanra ,&nbsp;Vadivelu Ramalingam ,&nbsp;Rahul Singhal ,&nbsp;Dinesh Choudhary ,&nbsp;Prabha Nini Gupta ,&nbsp;B Hygriv Rao ,&nbsp;Saurabh Mehrotra ,&nbsp;Vanita Arora ,&nbsp;Sanjeev Kathuria ,&nbsp;Pawan Suri ,&nbsp;David Benditt ,&nbsp;Richard Sutton","doi":"10.1016/j.ihj.2025.03.014","DOIUrl":"10.1016/j.ihj.2025.03.014","url":null,"abstract":"<div><div>The Head-Up Tilt Test (HUTT) has been widely used for the past four decades as part of the overall assessment of the potential causes of collapse in patients with recurring transient loss of consciousness (TLOC) of unknown cause. The ability of a positive HUTT often to reproduce patient symptoms and illustrate to the patient that the physician is confident of the diagnosis have been major advances in clinical TLOC management. Tilt testing has been particularly important in understanding and diagnosing vasovagal syncope (VVS) and orthostatic hypotension.</div><div>Despite HUTT having great clinical utility, different HUTT protocols and drug provocations result in different test yields. Limited HUTT reproducibility has led some researchers to criticize HUTT utility. As in most medical tests, limitations are part of the test.</div><div>Herein, we provide a contemporary review of HUTT's utility in diagnosing and managing various TLOC disorders with intent to clarify its role in clinical practice.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 3","pages":"Pages 243-251"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}