The Role of Right Ventricular Contractility in Patients Who Experienced Neurogenic Syncope

Abstract

Introduction: Left ventricular hyper contractility has been thought to have a major role at early phases of vasovagal syncope. However the right ventricular function during syncope has not been delineated clearly. The present study evaluated the right myocardial contractility in patients who experienced vasovagal syncope during head-up tilt test (HUTT). Patients and Methods: A total of 89 Patients, who experienced syncope between January 2012 and March 2014, were included in the study. All the patients underwent HUTT and were followed by transthoracic echocardiography. Results: Fifty patients experienced syncope during HUTT. There was no significant difference between the patients, who experienced syncope versus who did not, in terms of gender, age, ejection fraction (p> 0.05). Mitral lateral annular systolic (s') velocity (14 ± 3.8 vs. 13.3 ± 3.6; p= 0.625), septal annular s' velocity (11 ± 3.7 vs. 10.3 ± 2; p= 0.951) were similar following HUTT in patients with and without syncope respectively. However, tricuspid valve lateral annular s' velocity after tilt testing was higher in patients, who experienced syncope (17 ± 2.7 vs. 15.1 ± 3.0; p= 0.003). Conclusion: While left ventricular functions are not affected, right ventricular contraction is more powerful in patients who experience syncope during HUTT.