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Frequency Domain Indices of Heart Rate Variability are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children.
J Pediatr. 2019 04; 207:59-63.JPed

Abstract

OBJECTIVE

To explore the value of frequency domain indices of heart rate variability (HRV) in the differential diagnosis between pediatric vasovagal syncope and postural tachycardia syndrome (POTS).

STUDY DESIGN

Eighty-five patients aged 7-16 years with either vasovagal syncope or POTS were enrolled in the experimental group; 18 healthy children served as controls. Holter electrocardiography was used to detect HRV frequency-domain indices in patients with vasovagal syncope, patients with POTS, and control subjects. The differences in HRV indices were compared between the vasovagal syncope and POTS groups. The receiver operating characteristic (ROC) curve was calculated to analyze the predictive value of HRV for the differential diagnosis between vasovagal syncope and POTS in children. In addition, 37 children aged 7-17 years with either vasovagal syncope or POTS were recruited as an external validation group.

RESULTS

The daytime ultra-low frequency (dULF), nighttime ULF (nULF), daytime very low frequency (dVLF), and nighttime VLF (nVLF) were higher in the vasovagal syncope group compared with the POTS group (P < .01 for dULF, dVLF, and nVLF; P < .05 for nULF). The dULF, nULF, dVLF, and nVLF yielded a sensitivity of 73.3%, 71.1%, 68.9%, and 62.2%, respectively, and a specificity of 72.5%, 62.5%, 60.0%, and 60.0%, respectively, to differentiate vasovagal syncope from POTS. The external validation with clinical diagnostic standard showed that a dULF cutoff value of 36.2 ms2 for differentiating POTS from vasovagal syncope yielded a sensitivity of 71.4%, a specificity of 75.0%, and an accuracy of 73.0%.

CONCLUSION

dULF may be a useful measure for the differential diagnosis between vasovagal syncope and POTS in adolescents.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Wang Y
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Zhang C
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Chen S
Division of Biological Sciences, University of California, San Diego, La Jolla, CA.
Li X
Department of Medical Statistics, Peking University First Hospital, Beijing, China.
Jin H
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Du J
Department of Pediatrics, Peking University First Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China. Electronic address: junbaodu1@126.com.

MeSH

AdolescentCase-Control StudiesChildDiagnosis, DifferentialElectrocardiography, AmbulatoryFemaleHeart RateHumansMalePostural Orthostatic Tachycardia SyndromeSensitivity and SpecificitySyncope, VasovagalTilt-Table Test

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

30626483

Citation

Wang, Yuanyuan, et al. "Frequency Domain Indices of Heart Rate Variability Are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children." The Journal of Pediatrics, vol. 207, 2019, pp. 59-63.
Wang Y, Zhang C, Chen S, et al. Frequency Domain Indices of Heart Rate Variability are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children. J Pediatr. 2019;207:59-63.
Wang, Y., Zhang, C., Chen, S., Li, X., Jin, H., & Du, J. (2019). Frequency Domain Indices of Heart Rate Variability are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children. The Journal of Pediatrics, 207, 59-63. https://doi.org/10.1016/j.jpeds.2018.11.054
Wang Y, et al. Frequency Domain Indices of Heart Rate Variability Are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children. J Pediatr. 2019;207:59-63. PubMed PMID: 30626483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequency Domain Indices of Heart Rate Variability are Useful for Differentiating Vasovagal Syncope and Postural Tachycardia Syndrome in Children. AU - Wang,Yuanyuan, AU - Zhang,Chunyu, AU - Chen,Selena, AU - Li,Xueying, AU - Jin,Hongfang, AU - Du,Junbao, Y1 - 2019/01/07/ PY - 2018/09/29/received PY - 2018/11/27/revised PY - 2018/11/29/accepted PY - 2019/1/11/pubmed PY - 2020/4/14/medline PY - 2019/1/11/entrez KW - children KW - heart rate variability KW - postural tachycardia syndrome KW - vasovagal syncope SP - 59 EP - 63 JF - The Journal of pediatrics JO - J Pediatr VL - 207 N2 - OBJECTIVE: To explore the value of frequency domain indices of heart rate variability (HRV) in the differential diagnosis between pediatric vasovagal syncope and postural tachycardia syndrome (POTS). STUDY DESIGN: Eighty-five patients aged 7-16 years with either vasovagal syncope or POTS were enrolled in the experimental group; 18 healthy children served as controls. Holter electrocardiography was used to detect HRV frequency-domain indices in patients with vasovagal syncope, patients with POTS, and control subjects. The differences in HRV indices were compared between the vasovagal syncope and POTS groups. The receiver operating characteristic (ROC) curve was calculated to analyze the predictive value of HRV for the differential diagnosis between vasovagal syncope and POTS in children. In addition, 37 children aged 7-17 years with either vasovagal syncope or POTS were recruited as an external validation group. RESULTS: The daytime ultra-low frequency (dULF), nighttime ULF (nULF), daytime very low frequency (dVLF), and nighttime VLF (nVLF) were higher in the vasovagal syncope group compared with the POTS group (P < .01 for dULF, dVLF, and nVLF; P < .05 for nULF). The dULF, nULF, dVLF, and nVLF yielded a sensitivity of 73.3%, 71.1%, 68.9%, and 62.2%, respectively, and a specificity of 72.5%, 62.5%, 60.0%, and 60.0%, respectively, to differentiate vasovagal syncope from POTS. The external validation with clinical diagnostic standard showed that a dULF cutoff value of 36.2 ms2 for differentiating POTS from vasovagal syncope yielded a sensitivity of 71.4%, a specificity of 75.0%, and an accuracy of 73.0%. CONCLUSION: dULF may be a useful measure for the differential diagnosis between vasovagal syncope and POTS in adolescents. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/30626483/Frequency_Domain_Indices_of_Heart_Rate_Variability_are_Useful_for_Differentiating_Vasovagal_Syncope_and_Postural_Tachycardia_Syndrome_in_Children_ DB - PRIME DP - Unbound Medicine ER -