An association between anxiety and neurocardiogenic syncope during head-uptilt table testing

To study the association between anxiety and neurocardiogenic syncope as de termined by head-up tilt table testing (HUT) in men and women with presynco pe or syncope, patients with unexplained syncope or presyncope undergoing H UT were asked to complete the Burns Anxiety Inventory (BAI), a validated in ventory of 33 questions with responses graded from 0 to 3. HUT consisted of a 30-minute tilt to 60 degrees, which if negative, was repeated with an is oproterenol infusion. A positive HUT was defined as symptomatic hypotension and/or bradycardia. Of the 66 patients who completed the BAI and underwent HUT, 33 were men and 33 were women. The mean age was 57 +/- 18 years (17-9 1 years). Patients with a positive HUT had a higher BAI score than those wi th a negative HUT (22 +/- 12 vs 14 +/- 13, P = 0.017). This association was stronger in women with a BAI score of 24 +/- 11 in those with a positive H UT versus 2 3 +/- 8 in those with a negative HUT (P = 0.005). In contrast, the mean BAI score for men with a positive HUT was 19 +/- 13, as compared t o 15 +/- 16 for a negative HUT (P = 0.5). In conclusion, the present study demonstrates a statistical association between anxiety (as determined by BA I) and HUT result. Gender-based analysis revealed a more statistically sign ificant relationship between anxiety and HUT outcome for women as compared to men.