{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T07:16:24Z","timestamp":1792739784691,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2003,9,5]],"date-time":"2003-09-05T00:00:00Z","timestamp":1062720000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p> <jats:italic>Introduction:<\/jats:italic> The combination of head\u2010up tilt and incremental lower body negative pressure has shown promise in the diagnosis of orthostatic hypotension and neurocardiogenic syncope, although prior methodologies limited conclusions as to the reproducibility of the test. The aim of this study was to assess the efficacy and reproducibility of a protocol combining tilt and stages of incremental lower body negative pressure.<\/jats:p><jats:p> <jats:italic>Methods and Results:<\/jats:italic> Ten volunteers (6 men and 4 women; mean age <jats:styled-content>21 \u00b1 1 years<\/jats:styled-content>) participated in the study, which was composed of three sessions, 1 month apart, each consisting of 60\u00b0 tilt followed by lower body suction in incremental levels of \u221210 mmHg for 5 minutes at each level. The primary outcome variable was the time to presyncope. Secondary variables were the levels of heart rate, blood pressure, cerebral blood flow, and end\u2010tidal CO<jats:sub>2<\/jats:sub> at each level of the test. Presyncope could be achieved in all subjects. The mean times to presyncope were <jats:styled-content>24.6 \u00b1 1.4 minutes, 26.2 \u00b1 1.8 minutes<\/jats:styled-content>, and <jats:styled-content>31.8 \u00b1 1.6 minutes<\/jats:styled-content> and were not different across tests <jats:styled-content>(P = 0.3)<\/jats:styled-content>. Intrasubject variability was assessed by determining the mean average deviation from the mean, which was <jats:styled-content>3.2 \u00b1 2.0 minutes<\/jats:styled-content>. Changes in heart rate, blood pressure, end\u2010tidal CO<jats:sub>2<\/jats:sub>, and cerebral blood flow were consistent with repeat testing.<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> Lower body negative pressure combined with head\u2010up tilt in a staged protocol can safely and reliably induce presyncope in all normal subjects tested. The test is a potent and reproducible investigational tool for inducing hypotension and transient cerebral hypoperfusion. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 14, pp. 920\u2010924, September 2003)<\/jats:italic><\/jats:p>","DOI":"10.1046\/j.1540-8167.2003.03065.x","type":"journal-article","created":{"date-parts":[[2003,9,5]],"date-time":"2003-09-05T09:59:16Z","timestamp":1062755956000},"page":"920-924","source":"Crossref","is-referenced-by-count":38,"title":["Combined Head\u2010Up Tilt and Lower Body Negative Pressure as an Experimental Model of Orthostatic Syncope"],"prefix":"10.1111","volume":"14","author":[{"given":"PAUL","family":"LELORIER","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GEORGE J.","family":"KLEIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANDREW","family":"KRAHN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RAYMOND","family":"YEE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALLAN","family":"SKANES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. KEVIN","family":"SHOEMAKER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,9,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(91)90005-T"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01828837"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.7.1672"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/24.3.214"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.2000.278.6.H1848"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0094-5765(92)90183-J"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198910000-00002"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.9.1876"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.9.1876"},{"key":"e_1_2_6_11_2","first-page":"985","article-title":"Inspiratory CO2 increases orthostatic tolerance during repeated tilt","volume":"72","author":"Blaber AP","year":"2001","journal-title":"Aviat Space Environ Med"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1540-8167.2003.03065.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1540-8167.2003.03065.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T10:53:37Z","timestamp":1694429617000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1540-8167.2003.03065.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,9]]},"references-count":10,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2003,9]]}},"alternative-id":["10.1046\/j.1540-8167.2003.03065.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1540-8167.2003.03065.x","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,9]]}}}