RT-37
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Increased salt intake prevents
vasovagal syncope during head-up tilt test
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Cinzia Forleo, Andrea Passantino,
Luana Ligurgo*, Francesco Massari, Paolo Totaro, Filippo Mastropasqua, Maria Vittoria
Pitzalis*, Paolo Rizzon*.
Cardiology "S. Maugeri" Foundation, IRCCS, Cassano, *Institute of Cardiology,
University of Bari, Italy
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Abstract
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Background. The otpimal treatment of
vasovagal syncope is still debated. The aim of the present study was to evaluate whether
an increased salt intake is able to prevent vasovagal syncope.
Methods. We studied 16 consecutive patients (11 females, 5 males,
mean age 33 ± 15 years) with a history of frequent syncope (> 3 in the last 3 months),
without cardiological and neurological diseases. All patients showed syncope or
pre-syncope in 2 consecutive tilt-up test (TUT). The TUT was performed by an electrically
motorized tilting bed. For each patients electrocardiogram and blood pressure were
continuously monitored. After 20 minutes during which patients remained in supine
position, the bed was tilted to 70 degrees until the patients showed syncope or
pre-syncope. In all patients sodium chloride at a dosage of 300 mEq/day was administered.
Plasma volume was measured at baseline and during salt intake by means of Evans blue
dilution method. Urinary sodium and potassium excretion were also analysed in both
conditions. After 47 ± 24 days of treatment, 15 patients were re-evaluated.
Results. One patient withdrew the treatment because of the appearance
of side effects (skin rash). After increased salt diet the TUT was negative in 11 patients
(73%) while 4 (27%) had syncope or pre-syncope. Plasma volume and daily urinary excretion
of sodium increased significantly (p < 0.05).
Conclusions. An increased salt intake is a promising therapy in
patients with vasovagal syncope. Its efficacy seems to be related to the ability of
increasing plasma volume; however, the identification of those patients who will benefit
needs further studies.
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Key Words
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Syncope
head-up tilt testing, salt intake, OA
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