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PREVALENCE AND CAUSES OF TRANSITORY LOSS OF CONSCIOUSNESS IN GENERAL POPULATION (BY THE DATA FROM ЭССЕ-RF TRIAL)

https://doi.org/10.15829/1560-4071-2014-8-43-48

Abstract

Aim. To study prevalence of transitory loss of consciousness (TLC) in general population of the city Samara and to suggest its genesis according to anamnestic data.

Material and methods. The material for the study was provided by a simple randomized selection of persons from general population in Samara city, performed during the multicentre observational trial "Epidemiology of Cardio-Vascular Diseases in the Regions of Russian Federation — ЭССЕ-RF". Total volume of the selection was 1796 persons (more than 80% responded to the call). Average age of the studied persons was 45,8±11,9 y., women — 1256 (69,9%), men — 540 (30,1%). In questionnaire module respondents analysed: 1) are there any cases of sudden death in family anamnesis at the age less than 45 y. and linked or suspicious to be linked to heart disease; 2) any complaints on palpitation; 3) presence of palpitations and their main characteristics; 4) episodes of TLC in anamnesis and their characteristics; and 14 questions more, than make it to suspect neuromediatory mechanism of TLC.

Results. The prevalence of TLC in analysed population was 23%, maximum at the age of 40-49 y., reaching 28%. TLC were 2 times more prevalent in women than in men (27,5% and 13,5% resp., p<0,01). Median of the age of first episode was 16 (11; 23) y. o., taken that in 333 (<85%) respondents at the age <30 y. o. Almost in the half of cases (53% men, 46% women) the first TLC occurred at the age between 10 and 19 y. o., and with increasing of age probability of TLC decreased to the minimum of 1% in women of 60-69 y.o.

The average length of anamnesis was 27,7 (12; 47) y. Most respondents (83,5%) had no any background somatic pathology. About the episodes of sudden death of immediate family members in younger age reported 27 persons (6,5%). Conclusion. In more than a half of patients, we found the signs showing a neuromediatory genesis of TLC (56%). These were the main cause for TLC in all age groups (50%-66%) as in men (60%) and women (55%). Th second cause was arrhythmic, having 6% of cases. In 35% the main cause for TLC by the method of questionnaire was not revealed.

About the Authors

S. A. Gudkova
SBHI Samara Region Clinical Cardiological Dispensary
Russian Federation


N. A. Cherepanova
SBHI Samara Region Clinical Cardiological Dispensary
Russian Federation


G. A. Golovina
FSBHI Samara Medical Clinical Centre of FMBA RF Toliatti
Russian Federation


D. V. Duplyakov
SBHI Samara Region Clinical Cardiological Dispensary SBEI HPE Samara State Medical University
Russian Federation


S. M. Khokhlunov
SBHI Samara Region Clinical Cardiological Dispensary SBEI HPE Samara State Medical University
Russian Federation


O. M. Rotar
FSBI Federal Medical Research Centre n.a. Almazov V. A. of the Ministry of Health, Saint-Petersburg, Russia
Russian Federation


A. O. Konradi
FSBI Federal Medical Research Centre n.a. Almazov V. A. of the Ministry of Health, Saint-Petersburg, Russia
Russian Federation


E. V. Schlyakhto
FSBI Federal Medical Research Centre n.a. Almazov V. A. of the Ministry of Health, Saint-Petersburg, Russia
Russian Federation


References

1. Soteriades ES, Evans JC, Larson MG, et al. Incidence and prognosis of syncope. N Engl J Med 2002; 347:878-85.

2. Brignole M, Alboni P, Benditt DG, et al. Guidelines on management (diagnosis and treatment) of syncope-Update 2004. Europace 2004; 6:467-537.

3. Moya A, Sutton R, Ammirati F, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30:2631-71.

4. Colman N, Nahm K, Ganzeboom KS, et al. Epidemiology of reflex syncope. Clin Auton Res 2004; 14 (Suppl 1): I/9-I/17.

5. Duplyakov DV, Golovina GA, Sysuenkova EV, et al. Evaluation of the probability of vasovagal syncope based on its history. Kardiologiia 2012; 52 (6): 55-60. Russian (Дупляков ДВ, Головина ГА, Сысуенкова ЕВ, и др. Оценка вероятности вазова- гальных обмороков, основанная на данных анамнеза. Кардиология 2012; 52 (6): 55-60).

6. Murdoch BD. Loss of consciousness in healthy South African men: incidence, causes and relationship to EEG abnormality. SA Med J 1980; 57: 771-4.

7. Lamb L, Green HC, Combs JJ, et al. Incidence of loss of consciousness in Air Force personnel. Aerospace Med 1960; 12:973-88.

8. Ganzeboom KS, Colman N, Reitsma JB, et al. Prevalence and triggers of syncope in medical students. Am J Cardiol 2003; 91: 1006-8.

9. Serletis A, Rose S, Sheldon AG, et al. Vasovagal syncope in medical students and their first-degree relatives. Eur Heart J 2006; 27: 1965-70.

10. Wieling W, Ganzeboom KS, Saul JP. Reflex syncope in children and adolescents. Heart 2004; 90:1094-100.

11. Brignole M, Menozzi C, Bartoletti A, et al. A new management of syncope. Prospective systematic guideline -based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006; 27: 76-82.

12. Accurso V, Winnicki M, Abu SM, et al. Predisposition to vasovagal syncope in subjects with blood/injury phobia. Circulation 2001; 104: 903-7.

13. Calkins H, Shyr Y Frumin H, et al. The value of clinical history in the differentiation of syncope due to ventricular tachycardia, atrioventricular block and neurocardiogenic syncope. Am J Med 1995; 98: 365-73.

14. Del Rosso A, Ungar A, Maggi R, et al. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart 2008; 94:1620-6.

15. Sheldon R, Rose S, Ritchie D, et al. Historical criteria that distinguish syncope from seizures. J Am Coll Cardiol 2002; 40: 142-8.

16. Van Dijk N, Boer KR, Colman N, et al. High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: The Fainting Assessment Study. J Cardiovasc Electrophysiol 2008; 19 (1): 48-55.

17. Ammirati F, Colivicchi F, Santini M. Diagnosing syncope in clinical practice. Implementation of a simplified diagnostic algorithm in a multicentre prospective trial — the OESIL 2 study (Osservatorio Epidemiologico della Sincope nel Lazio). Eur Heart J 2000; 21: 935-40.

18. Sarasin FP, Louis-Simonet M, Carballo D, et al. Prospective evaluation of patients with syncope: a population-based study. Am J Med 2001; 111: 177-84.

19. Blanc JJ, L'her C, Touiza A, et al. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 2002; 23: 815-20.

20. Farwell D, Sulke N. How do we diagnose syncope? J Cardiovasc E lectrophysiol 2002; 13: S9-S13.

21. Disertori M, Brignole M, Menozzi C, et al. Management of patients with syncope referred urgently to general hospitals. Europace 2003; 5: 283-91.

22. Colman N, Bakker A, Linzer M, et al. Value of history-taking in syncope patients: in whom to suspect long QT syndrome? Europace 2009; 11 (7): 937-43.

23. Romme JJCM, Van Dijk N, Boer KR, et al. Diagnosing vasovagal syncope based on quantitative history-taking: validation of the Calgary Syncope Symptom Score. Eur Heart J 2009; 30:2888-96.

24. Duplyakov DV, Golovina GA, Gavrilova EA, et al. Disputable issues of pathogenesis of neurocardiological syncope. Vestn Arrhythm 2008;51:44-9. Russian. (Дупляков ДВ, Головина ГА, Гаврилова ЕА, Сысуенкова ЕВ. Спорные вопросы патогенеза нейроме- диаторных синкопов. Вестник аритмологии. 2008; 51:44-9).

25. Duplyakov DV, Golovina GA, Garkina SV, et al. Neurocardiogenic syncope and temporal lobe epilepsy — are there any common features of pathogenesis? Vestn Arrhythm 2008; 54:74-7. Russian (Дупляков ДВ, Головина ГА, Гарькина СВ и др. Нейрокардиогенный обморок и височная эпилепсия — есть ли общие стороны патогенеза. Вестник арит- мологии 2008; 54:74-7).

26. Strickberger SA, Benson DW, Biaggioni I, et al. AHA/ACCF scientific statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation In Collaboration With the Heart Rhythm Society. J Am Coll Cardiol 2006; 47: 473-84.

27. Kapoor WN. Current evaluation and management of syncope. Circulation 2002; 106: 1606-9.

28. Merlos P, Rumiz E, Ruiz-Granell R, et al. Outcome of patients with syncope beyond the implantable loop recorder. Europace 2013; 15: 122-6


Review

For citations:


Gudkova S.A., Cherepanova N.A., Golovina G.A., Duplyakov D.V., Khokhlunov S.M., Rotar O.M., Konradi A.O., Schlyakhto E.V. PREVALENCE AND CAUSES OF TRANSITORY LOSS OF CONSCIOUSNESS IN GENERAL POPULATION (BY THE DATA FROM ЭССЕ-RF TRIAL). Russian Journal of Cardiology. 2014;(8):43-48. (In Russ.) https://doi.org/10.15829/1560-4071-2014-8-43-48

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)