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Purpose <p>This prospective observational study was carried out to evaluate the response of adrenocortical hormones (cortisol and aldosterone) to head-up tilt (HUT)-induced vasovagal syncope in relation to hemodynamic changes.</p> Subjects and methods <p>Blood samples from 79 patients (48 women and 31 men, age 19–73&#xa0;years) who underwent the HUT test were analyzed for serum aldosterone and cortisol. On the basis of their response, patients were categorized into two groups: 50 HUT-positive (HUT+) and 29 HUT-negative (HUT−) patients.</p> Results <p>HUT+ patients exhibited significantly lower baseline aldosterone levels compared with HUT− patients (203.1 ± 78.8 versus 266.2 ± 76.3&#xa0;pg/ml, <i>p</i> = 0.0009). Similarly, aldosterone levels after the HUT test were lower in the HUT+ as compared with the HUT− group (249.5 ± 101.3 versus 351.4 ± 98.11&#xa0;pg/ml, <i>p</i> &lt; 0.0001). However, serum cortisol showed no significant differences between groups. Aldosterone increased in response to HUT in both groups. Aldosterone positively correlated with systolic and diastolic blood pressure, as well as heart rate. Integration of aldosterone with clinical assessment and additional laboratory tests may improve diagnostic accuracy and risk stratification.</p> Conclusions <p>The results demonstrate significantly lower serum aldosterone concentrations in HUT+ patients at baseline and after HUT test in comparison with HUT− patients. Moreover, aldosterone levels positively correlated with systolic and diastolic blood pressure (BP). However, serum cortisol levels did not discriminate HUT+ from HUT− patients.</p>

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Adrenocortical response during HUT test in patients with vasovagal syncope

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月18日

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  • Barbora Pavlovič Bačkorová,
  • Zora Lazúrová,
  • Monika Lukáčová,
  • Kristína Valová,
  • Peter Mitro,
  • Ivica Lazúrová

摘要

Purpose

This prospective observational study was carried out to evaluate the response of adrenocortical hormones (cortisol and aldosterone) to head-up tilt (HUT)-induced vasovagal syncope in relation to hemodynamic changes.

Subjects and methods

Blood samples from 79 patients (48 women and 31 men, age 19–73 years) who underwent the HUT test were analyzed for serum aldosterone and cortisol. On the basis of their response, patients were categorized into two groups: 50 HUT-positive (HUT+) and 29 HUT-negative (HUT−) patients.

Results

HUT+ patients exhibited significantly lower baseline aldosterone levels compared with HUT− patients (203.1 ± 78.8 versus 266.2 ± 76.3 pg/ml, p = 0.0009). Similarly, aldosterone levels after the HUT test were lower in the HUT+ as compared with the HUT− group (249.5 ± 101.3 versus 351.4 ± 98.11 pg/ml, p < 0.0001). However, serum cortisol showed no significant differences between groups. Aldosterone increased in response to HUT in both groups. Aldosterone positively correlated with systolic and diastolic blood pressure, as well as heart rate. Integration of aldosterone with clinical assessment and additional laboratory tests may improve diagnostic accuracy and risk stratification.

Conclusions

The results demonstrate significantly lower serum aldosterone concentrations in HUT+ patients at baseline and after HUT test in comparison with HUT− patients. Moreover, aldosterone levels positively correlated with systolic and diastolic blood pressure (BP). However, serum cortisol levels did not discriminate HUT+ from HUT− patients.