Research Progress on the Application of Cerebrocardiac Combined Multimodal Examination in the Diagnosis of Vasovagal Syncope

doi:10.3969/j.issn.1673-5765.2025.11.006

Abstract

Abstract: Vasovagal syncope (VVS), as the most common type of syncope, is highly dependent on the head-up tilt test (HUTT) for diagnosis. However, this gold standard also has several limitations. In recent years, cerebrocardiac combined multimodal examination has emerged, aiming to enhance diagnostic performance by integrating functional imaging techniques. Among these, the synchronous combined mode (HUTT combined with TCD or near infrared spectrometry) has demonstrated core value in enhancing diagnostic accuracy and efficiency, as well as improving examination safety. Meanwhile, the asynchronous combination of HUTT with advanced imaging techniques such as cerebral blood flow perfusion imaging or functional magnetic resonance imaging plays a significant role in the differential diagnosis of VVS and the in-depth analysis of its central regulatory mechanisms. The application of cerebrocardiac combined multimodal examination aims to promote the advancement of VVS diagnosis and treatment toward precision and individualization.

Key words: Vasovagal syncope; Head-up tilt test; Transcranial Doppler; Near infrared spectrometry; Cerebral blood flow perfusion imaging; Multimodal examination

摘要： 血管迷走性晕厥（vasovagal syncope，VVS）作为最常见的晕厥类型，其诊断高度依赖直立倾斜试验（head-up tilt test，HUTT），但该金标准也存在诸多不足。近年来，脑心联合多模态检查应运而生，旨在通过整合功能性影像技术提升诊断效能。其中，同步联合模式（HUTT联合TCD或近红外光谱法）已展现出在提升诊断准确性和效率、改善检查安全性方面的核心价值。同时，HUTT与脑血流灌注显像或功能性MRI等高级影像技术的非同步结合，在VVS的鉴别诊断及其中枢调控机制的深入解析中发挥重要作用。脑心联合多模态检查的应用旨在推动VVS诊疗向精准化、个体化迈进。

关键词: 血管迷走性晕厥; 直立倾斜试验; 经颅多普勒; 近红外光谱法; 脑血流灌注显像; 多模态检查

CLC Number:

WANG Jingyi, XIONG Yunhui, JIANG Hongliang, CAO Liming. Research Progress on the Application of Cerebrocardiac Combined Multimodal Examination in the Diagnosis of Vasovagal Syncope[J]. Chinese Journal of Stroke, 2025, 20(11): 1380-1386.

王静祎, 熊纭辉, 江红亮, 曹黎明. 脑心联合多模态检查在血管迷走性晕厥诊断中的应用研究进展[J]. 中国卒中杂志, 2025, 20(11): 1380-1386.

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