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[Hemodynamic changes during head-up tilt test and predictive value thereof in predicting the efficacy of metoprolol therapy in children with vasovagal syncope].
Zhonghua Yi Xue Za Zhi. 2007 May 15; 87(18):1260-2.ZY

Abstract

OBJECTIVE

To investigate the value of hemodynamic changes during head-up tilt (HUT) test and predictive value thereof in evaluating the efficacy of metoprolol therapy in children with vasovagal syncope (VSS).

METHODS

Twenty-six consecutive children with history of VSS diagnosed by head-up tilt (HUT) or sublingual nitroglycerin potentiated head-up tilt (SNHUT), who were treated with metoprolol for 6 approximately 12 months and followed up for (18 +/- 9) months (12 approximately 36 months), were divided into two groups according to effect of metoprolol: effective treatment group (n = 16, aged 12 +/- 2) without VSS recurrence during treatment and fellow-up, and futile treatment group (n = 10, aged 12 +/- 3). The heart rate changes during HUT or SNHUT were evaluated between the two groups.

RESULTS

There were no significant differences between these 2 groups with regard to the demographic and clinical characteristics including age, gender, history, syncope spells, follow-up time and heart rate, mean blood pressure in supine position and during positive response. For example, the baseline heart rate of the effective treatment group was 81 +/- 12 beats/min, not significantly different from that of the futile treatment group (78 +/- 8 beats/min, P = 0.804). However, during tilt test 16 of the 26 patients in the effective treatment group showed tachycardia before positive response, with the mean heart rate of (123 +/- 15) beats/min, whereas all 10 patients in the futile group did not have tachycardia before positive response, with the mean heart rate of (96 +/- 17) beats/min. If an increase of 30 beats/min was taken as a borderline in heart rate during positive response in HUT compared with that of baseline value, in respect of predicting the metoprolol efficacy in the treatment of VVS, the sensitivity was 81% (13/16), the specificity was 80% (8/10), and the diagnostic value was 81% (21/26).

CONCLUSION

A marked increase in heart rate in HUT or SNHUT is a better predictor of metoprolol efficacy in the treatment of children with VVS.

Links

Publisher Full Text

Authors+Show Affiliations

Zhang QY
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
DU JB
No affiliation info available
Zhen JL
No affiliation info available
Li WZ
No affiliation info available
Wang YL
No affiliation info available

MeSH

AdolescentAdrenergic beta-AntagonistsBlood PressureChildFemaleHeart RateHumansMaleMetoprololRetrospective StudiesSyncope, VasovagalTilt-Table TestTreatment Outcome

Pub Type(s)

Clinical Trial
English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

17686261

Citation

Zhang, Qing-you, et al. "[Hemodynamic Changes During Head-up Tilt Test and Predictive Value Thereof in Predicting the Efficacy of Metoprolol Therapy in Children With Vasovagal Syncope]." Zhonghua Yi Xue Za Zhi, vol. 87, no. 18, 2007, pp. 1260-2.
Zhang QY, DU JB, Zhen JL, et al. [Hemodynamic changes during head-up tilt test and predictive value thereof in predicting the efficacy of metoprolol therapy in children with vasovagal syncope]. Zhonghua Yi Xue Za Zhi. 2007;87(18):1260-2.
Zhang, Q. Y., DU, J. B., Zhen, J. L., Li, W. Z., & Wang, Y. L. (2007). [Hemodynamic changes during head-up tilt test and predictive value thereof in predicting the efficacy of metoprolol therapy in children with vasovagal syncope]. Zhonghua Yi Xue Za Zhi, 87(18), 1260-2.
Zhang QY, et al. [Hemodynamic Changes During Head-up Tilt Test and Predictive Value Thereof in Predicting the Efficacy of Metoprolol Therapy in Children With Vasovagal Syncope]. Zhonghua Yi Xue Za Zhi. 2007 May 15;87(18):1260-2. PubMed PMID: 17686261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hemodynamic changes during head-up tilt test and predictive value thereof in predicting the efficacy of metoprolol therapy in children with vasovagal syncope]. AU - Zhang,Qing-you, AU - DU,Jun-bao, AU - Zhen,Jing-lan, AU - Li,Wan-zhen, AU - Wang,Yu-li, PY - 2007/8/10/pubmed PY - 2008/11/13/medline PY - 2007/8/10/entrez SP - 1260 EP - 2 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 87 IS - 18 N2 - OBJECTIVE: To investigate the value of hemodynamic changes during head-up tilt (HUT) test and predictive value thereof in evaluating the efficacy of metoprolol therapy in children with vasovagal syncope (VSS). METHODS: Twenty-six consecutive children with history of VSS diagnosed by head-up tilt (HUT) or sublingual nitroglycerin potentiated head-up tilt (SNHUT), who were treated with metoprolol for 6 approximately 12 months and followed up for (18 +/- 9) months (12 approximately 36 months), were divided into two groups according to effect of metoprolol: effective treatment group (n = 16, aged 12 +/- 2) without VSS recurrence during treatment and fellow-up, and futile treatment group (n = 10, aged 12 +/- 3). The heart rate changes during HUT or SNHUT were evaluated between the two groups. RESULTS: There were no significant differences between these 2 groups with regard to the demographic and clinical characteristics including age, gender, history, syncope spells, follow-up time and heart rate, mean blood pressure in supine position and during positive response. For example, the baseline heart rate of the effective treatment group was 81 +/- 12 beats/min, not significantly different from that of the futile treatment group (78 +/- 8 beats/min, P = 0.804). However, during tilt test 16 of the 26 patients in the effective treatment group showed tachycardia before positive response, with the mean heart rate of (123 +/- 15) beats/min, whereas all 10 patients in the futile group did not have tachycardia before positive response, with the mean heart rate of (96 +/- 17) beats/min. If an increase of 30 beats/min was taken as a borderline in heart rate during positive response in HUT compared with that of baseline value, in respect of predicting the metoprolol efficacy in the treatment of VVS, the sensitivity was 81% (13/16), the specificity was 80% (8/10), and the diagnostic value was 81% (21/26). CONCLUSION: A marked increase in heart rate in HUT or SNHUT is a better predictor of metoprolol efficacy in the treatment of children with VVS. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/17686261/[Hemodynamic_changes_during_head_up_tilt_test_and_predictive_value_thereof_in_predicting_the_efficacy_of_metoprolol_therapy_in_children_with_vasovagal_syncope]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0376-2491&year=2007&vol=87&issue=18&fpage=1260 DB - PRIME DP - Unbound Medicine ER -