Trial: Neurocardiogenic Mechanisms of Unexplained Syncope in Idiopathic Dilated Cardiomyopathy

Authors: Livanis EG, Kostopoulou A, Theodorakis GN, Aggelopoulou N, Adamopoulos S, Degiannis D, Kremastinos DT.

Reference: The American Journal of Cardiology

Volume 99, Issue 4, 15 February 2007, Pages 558-562

Purpose: To examine the implication of neurally mediated mechanisms in the pathophysiology of syncopal episodes in patients with dilated cardiomyopathy.

Number of Patients:  26

Number of Centers: 1

Design:  Patients with dilated cardiomyopathy and left ventricular ejection fractions ≤40% were included in the study. Thirteen patients with unexplained syncope or presyncope and a control group of 13 patients without unexplained syncope underwent head-up tilt tests with clomipramine challenge. Heart rate variability analysis and plethysmography of forearm flow were performed during the tilt tests. Blood samples were also drawn for catecholamine measurements.

Authors Conclusion: Neurally mediated mechanisms seem to be implicated in the pathophysiology of syncope in patients with DC and should therefore be considered in the differential diagnosis of syncopal episodes of unexplained origin.

Key words:  syncope, dilated cardiomyopathy, head up tilt

Summary written by Paul Friedman, MD