В обзоре приведена характеристика ортостатических проб и, прежде всего, тилт-теста – пробы с длительным пассивным ортостазом, применяемых в диагностике рефлекторных (нейромедиаторных) обмороков. Их характеристика базируется на Рекомендациях по диагностике и лечению обмороков (Рекомендации Европейского общества кардиологов ESC 2018 г., рекомендации Американской Ассоциации сердца 2017 г.). Особое внимание обращено на показания и противопоказания к их проведению, а также оценку полученных результатов.

1. Бова А. А. Синкопальные состояния в клинической практике: учеб.-метод. пособие. – Минск: Асобны, 2009. – 45 с.

2. Вегетативные расстройства: клиника, лечение, диагностика / Под ред. А. М. Вейна. - М.: Медицинское информационное агентство, 2000. – 752 с.

3. Гуков А. О., Жданов А. М. // Кардиология. – 2000. – № 2. – С. 92–96.

4. Макаров Л. М. Тилт-тест в оценке синкопальных состояний у детей и подростков.- Практическая медицина, 2015. – С. 14–20.

5. Метелкина Л. П., Верещагин К. В. // Нейрохирургия. – 2005. – № 4. – С. 7–12.

6. Сметнев А. С., Шевченко Н. М., Гросу А. А. Синкопальные состояния // Кардиология. – 1988. – № 2. – С. 107–110.

7. Сычев О. С., Фролов А. И., Епанчинцева О. А., Лизогуб С. В. Синкопальные состояния в кардиологической практике: учеб.-метод. пособие. – Киев, 2005. – 32 с.

8. Сычев О. С., Фролов А. И., Епанчинцева О. А., Лизогуб С. В. Синкопальные состояния в кардиологической практике // Medicus Amicus. – 2006. – 6 с.

9. Хирманов В. Н., Русанов О. А., Джармукли Н. Этиология и прогноз синкопальных состояний у пациентов старше 35 лет // Кардиоваскулярная терапия и профилактика 2007; 6 (1): 84-8.

10. Alboni P, Alboni M, Bertorelle G. The origin of vasovagal syncope: to protect the heart or to escape predation? Clin Auton Res 2008;18:170-178.

11. Alboni P, Brignole M, et al. Is vasovagal syncope a disease? // Europace 2007; 9: 83-7.

12. Alboni P, Brignole M, Menozzi C, et al. The diagnostic value of history in patients with syncope with or without heart disease // J Am Coll Cardiol 2001; 37: 1921-8.

13. Bartoletti A, Alboni P, Ammirati F, Brignole M, Del Rosso A, Foglia Manzillo G, Menozzi C, Raviele A, Sutton R. 'The Italian Protocol': a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope. Europace 2000;2:339-342.

14. Benditt DG, Ferguson DW, Grubb BP, Kapoor WN, Kugler J, Lerman BB, Maloney JD, Raviele A, Ross B, Sutton R, Wolk MJ, Wood DL. Tilt table testing for assessing syncope. American College of Cardiology. J Am Coll Cardiol 1996;28:263-275.

15. Brignole M, Alboni P, Benditt DG, Bergfeldt L, Blanc JJ, Bloch Thomsen PE, van Dijk JG, Fitzpatrick A, Hohnloser S, Janousek J, Kapoor W, Kenny RA, Kulakowski P, Masotti G, Moya A, Raviele A, Sutton R, Theodorakis G, Ungar A, Wieling W; Task Force on Syncope, European Society of Cardiology. Guidelines on management (diagnosis and treatment) of syncope–update 2004.Europace 2004;6:467-537.

16. Brignole (Chairman) M., Alboni P., Benditt D., Bergfeldt L., Blanc J. J., Bloch Thomsen P. E., van Dijk J. G., Fitzpatrick A., Hohnloser S., Janousek J., Kapoor W., Kenny R. A., Kulakowski P., Moya A., Raviele A., Sutton R., Theodorakis G. and Wieling W. Guidelines on management (diagnosis and treatment) of syncope. // European Heart Journal (2001); 22, 1256–1306.

17. Brignole M, Suttov R, Menozzi C, et al. Early application of an implantable loop recorder allows effective specifi c therapy in patients with recurrent suspected neurally mediated syncope // Eur Heart J 2006; 27: 1085-92.

18. Brignole M., Moya A., Lange F. J. et al. (2018) 2018 ESC Guidelines for the diagnosis and management of syncope. Eur. Heart J., 39(21): 1883–1948.

19. Colman N, Nahm K, Ganzeboom KS, Shen WK, Reitsma J, Linzer M, WielingW, Kaufmann H. Epidemiology of reflex syncope. Clin Auton Res 2004;14(Suppl 1):19-117.

20. de Castro RR, Mesquita ET, da Nobrega AC. Parasympathetic-mediated atrial fibrillation during tilt test associated with increased baroreflex sensitivity. Europace 2006;8:349-351.

21. Fitzpatrick AP, Theodorakis G, Vardas P. et al. The incidence of malignant vasovagal syndrome in patients with recurrent syncope // Eur Heart J 1991; 12: 389-94.

22. Ganzeboom KS, Colman N, Reitsma JB, Shen WK, Wieling W. Prevalence and triggers of syncope in medical students. Am J Cardiol 2003;91:1006-1008.

23. Ganzeboom KS, Mairuhu G, Reitsma J, Linzer M, Wieling W, van Dijk N. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35–60 years. J Cardiovasc Electrophysiol 2006;17:1172-1176.

24. Grubb B. P. Neurocardiogenic syncope // N Engl J Med 2005; 352: 1004-10.

25. Grubb BP, Kosinski DJ, Boehm K, Kip K. The postural orthostatic tachycardia syndrome: a neurocardiogenic variant identified during head-up tilt table testing. Pacing Clin Electrophysiol 1997;20:2205-2212.

26. Hainsworth R. Syncope and fainting: classification and pathophysiological basis. In: Mathias CJ, Bannister R, eds. Autonomic Failure. A textbook of clinical disorders of the autonomic nervous system, 4th edn. // Oxford: Oxford University Press, 1999: 428–36.

27. Heitterachi E, Lord SR, Meyerkort P, McCloskey I, Fitzpatrick R. BP changes on upright tilting predict falls in older people. Age Ageing 2002;31:181-186.

28. Hermosillo AG, Falcon JC, Marquez MF, et al. Positive head-up tilt table test in patients with the long QT syndrome // Europace 1999; 1: 213-7.

29. Kenny RA, Ingram A, Bayliss J, Sutton R. Head-up tilt: a useful test for investigating unexplained syncope. Lancet 1986;1:1352- 1355.

30. Kenny RA, O'Shea D, Parry SW. The Newcastle protocols for head-up tilt table testing in the diagnosis of vasovagal syncope, carotid sinus hypersensitivity, and related disorders. Heart 2000;83:564-569.

31. Mathias CJ, Mallipeddi R, Bleasdale-Barr K. Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy. J Neurol 1999;246:893-898.

32. Morillo CA, Klein GJ, Zandri S, Yee R. Diagnostic accuracy of a low-dose isoproterenol head-up tilt protocol. Am Heart J 1995;129:901-906.

33. Moya A., Sutton R., Ammirati F. et al. Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Eur. Heart J. 2009; 2631–71. DOI: 10.1093/eurheartj/ehp298.

34. Naschitz J, Rosner I. Orthostatic hypotension: framework of the syndrome. Postgrad Med J 2007;83:568-574.

35. Olshansky B, Hahn EA, Hartz VL, Prater SP, Mason JW. Clinical significance of syncope in the electrophysiologic study versus electrocardiographic monitoring (ESVEM) trial. The ESVEM Investigators. Am Heart J 1999;137:878-886.

36. Parry SW, Gray JC, Baptist M, O'Shea D, Newton JL, Kenny RA. ‘Front-loaded' glyceryl trinitrate-head-up tilt table testing: validation of a rapid first line tilt protocol for the diagnosis of vasovagal syncope. Age Ageing 2008;37:411-415.

37. Paul M, Gerss J, Schulze-Bahr E, Wichter T, Vahlhaus C, Wilde AA, Breithardt G, Eckardt L. Role of programmed ventricular stimulation in patients with Brugada syndrome: a meta-analysis of worldwide published data. Eur Heart J 2007;28: 2126-2133.

38. Podoleanu C, Maggi R, Brignole M, Croci F, Incze A, Solano A, Puggioni E, Carasca E. Lower limb and abdominal compression bandages prevent progressive orthostatic hypotension in the elderly. A randomized placebo-controlled study. J Am Coll Cardiol 2006;48:1425-1432.

39. Raviele A, Giada F, Brignole M et al. Comparison of diagnostic accuracy of sublingual nitroglycerin test and low-dose isoproterenol test in patients with unexplained syncope // Am J Cardiol 2000; 85: 1194-8.

40. Sheldon R, Rose S, Connolly S et al. Diagnostic criteria for vasovagal syncope based on a quantitative history // Eur Heart J 2006; 27: 344-50.

41. Shen W. K., Sheldon R. S., Benditt D. G. et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J. Am. Coll. Cardiol. 2017: 4–59. DOI:10.1161/CIR.499.

42. Smit AAJ, Halliwill JR, Low PA, Wieling W. Topical Review. Pathophysiological basis of orthostatic hypotension in autonomic failure. J Physiol 1999; 519: 1–10.

43. Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, Levy D. Incidence and prognosis of syncope. N Engl J Med 2002;347:878-885.

44. Strickberger SA, Benson DW, Biaggioni I et al. AHA/ ACCF scientifi c 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.

45. Sutton R., Blompton D. M. Indications, methodology, and classification of results of tilt-table testing // Am. J. Сard.- 1999.- V.84. – P. 10-19.

46. 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.

47. Wieling W, Ganzeboom KS, Saul JP. Reflex syncope in children and adolescents. Heart 2004;90:1094-1100.

48. Zaidi A, Clough P, Cooper P, Scheepers B, Fitzpatrick AP. Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000;36:181-184.

49. Zareba W, Moss AJ, Le Cessie S, Locati EH, Robinson JL, Hall WJ, Andrews ML. Risk of cardiac events in family members of patients with Long QT syndrome. J Am Coll Cardiol 1995;26:1685-1691.