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Abstract：
An expert committee was formed to reach consensus on the use of tilt table testing (TTT) in the diagnosis of disorders that may cause transient loss of consciousness (TLOC) and to outline when other provocative cardiovascular autonomic tests are needed. While TTT adds to history taking, it cannot be a substitute for it. An abnormal TTT result is most meaningful if the provoked event is recognised by patients or eyewitnesses as similar to spontaneous events. The minimum requirements to perform TTT are a tilt table, a continuous beat-to-beat blood pressure monitor, at least one ECG lead, protocols for the indications stated below and trained staff. This basic equipment lends itself to the performance of (1) additional provocation tests, such as the active standing test, carotid sinus massage and autonomic function tests; (2) additional measurements, such as video, EEG, transcranial Doppler, NIRS, end-tidal CO2 or neuro-endocrine tests; and (3) tailor-made provocation procedures in those with a specific and consistent trigger of TLOC. TTT and other provocative cardiovascular autonomic tests are indicated if the initial evaluation does not yield a definite or highly likely diagnosis, but raises a suspicion of (1) reflex syncope, (2) the three forms of orthostatic hypotension (OH), i.e. initial, classic and delayed OH, as well as delayed orthostatic blood pressure recovery, (3) postural orthostatic tachycardia syndrome or (4) psychogenic pseudosyncope. A therapeutic indication for TTT is to teach patients with reflex syncope and OH to recognise hypotensive symptoms and to perform physical counter manoeuvres.
摘要：
成立了一个专家委员会，以就使用倾斜台测试（TTT）诊断可能导致短暂性意识丧失（TLOC）的疾病达成共识，并概述何时需要进行其他挑衅性心血管自主神经测试。虽然TTT增加了历史记录，它不能代替它。如果引发的事件被患者或目击者认为与自发事件相似，则异常的TTT结果最有意义。执行TTT的最低要求是倾斜台，一个连续的逐次跳动的血压监测仪，至少一个心电图导联,以下适应症的协议和训练有素的工作人员。这种基本设备适用于(1)额外的挑衅测试的性能，例如主动站立测试，颈动脉窦按摩和自主功能测试;(2)额外的测量,比如视频,脑电图,经颅多普勒,NIRS,潮气末CO2或神经内分泌测试；（3）在具有特定和一致触发TLOC的人中量身定制的挑衅程序。TTT和其他挑衅性心血管自主神经试验表明，如果初步评估不能产生明确的或极有可能的诊断，但怀疑（1）反射性晕厥，（2）直立性低血压（OH）的三种形式，即初始，经典和延迟OH，以及延迟的体位血压恢复，（3）体位性心动过速综合征或（4）心理性假性晕厥。TTT的治疗适应症是教导患有反射性晕厥和OH的患者识别低血压症状并进行物理对抗操作。
