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Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children.
Front Pediatr. 2022; 10:758100.FP

Abstract

Objectives

To explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients.

Materials and Methods

Pediatric patients with VVS or POTS, hospitalized in Peking University First Hospital between January 2012 and December 2018, were included in a derivation study. The transverse axis (T), longitudinal axis (L), T/L ratio, product T × L, distance between the origin and the proximal end of the longitudinal axis (pro-D), and distance between the origin and distal end of the longitudinal axis (dis-D) of the Poincaré plot were compared between the VVS and POTS groups, and the differential diagnostic performance of the above-mentioned graphic parameters was evaluated using receiver operating characteristic curve analysis. A validation study was conducted in pediatric patients hospitalized between January 2019 and December 2020.

Results

In school-aged children, the T, L, T/L, T × L, and dis-D values of patients with VVS were greater than those of patients with POTS; in adolescents, the T, T/L, T × L, and pro-D values of patients with VVS were greater than those of patients with POTS. Using a T/L cut-off value of 0.3 to distinguish between the two diseases, the sensitivity and specificity were 91.0 and 90.5%, respectively, for the total participants; 91.6 and 88.9%, respectively, for the school-aged children; and 82.1 and 95.7%, respectively, for the adolescents. In the validation study, a T/L cut-off value of 0.3 yielded an accuracy, sensitivity, and specificity of 81.8, 87.2, and 77.6%, respectively, in the total participants; 76.5, 82.6, and 71.4%, respectively, in the school-aged children; and 89.2, 93.8, and 85.7%, respectively, in the adolescents, in distinguishing VVS from POTS validated by clinical diagnosis.

Conclusions

The graphic parameters of the Poincaré plot are significantly different between VVS and POTS in pediatric patients, and the T/L of the Poincaré plot may be a useful measure to help differentiate VVS from POTS in children and adolescents.

Links

Authors+Show Affiliations

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Wang Xuan Institute of Computer Science, Peking University, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China. Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35372154

Citation

Yuan, Piaoliu, et al. "Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children." Frontiers in Pediatrics, vol. 10, 2022, p. 758100.

Yuan P, Lian Z, Wang Y, et al. Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children. Front Pediatr. 2022;10:758100.

Yuan, P., Lian, Z., Wang, Y., Wang, Y., Zhang, C., Du, J., Huang, Y., & Liao, Y. (2022). Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children. Frontiers in Pediatrics, 10, 758100. https://doi.org/10.3389/fped.2022.758100

Yuan P, et al. Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children. Front Pediatr. 2022;10:758100. PubMed PMID: 35372154.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children. AU - Yuan,Piaoliu, AU - Lian,Zhouhui, AU - Wang,Yuanyuan, AU - Wang,Yaru, AU - Zhang,Chunyu, AU - Du,Junbao, AU - Huang,Yaqian, AU - Liao,Ying, Y1 - 2022/03/10/ PY - 2021/08/13/received PY - 2022/02/09/accepted PY - 2022/4/4/entrez PY - 2022/4/5/pubmed PY - 2022/4/5/medline KW - Holter KW - Lorenz-RR scatterplot KW - Poincaré plot KW - children KW - orthostatic intolerance KW - postural tachycardia syndrome KW - syncope KW - vasovagal syncope SP - 758100 EP - 758100 JF - Frontiers in pediatrics JO - Front Pediatr VL - 10 N2 - Objectives: To explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients. Materials and Methods: Pediatric patients with VVS or POTS, hospitalized in Peking University First Hospital between January 2012 and December 2018, were included in a derivation study. The transverse axis (T), longitudinal axis (L), T/L ratio, product T × L, distance between the origin and the proximal end of the longitudinal axis (pro-D), and distance between the origin and distal end of the longitudinal axis (dis-D) of the Poincaré plot were compared between the VVS and POTS groups, and the differential diagnostic performance of the above-mentioned graphic parameters was evaluated using receiver operating characteristic curve analysis. A validation study was conducted in pediatric patients hospitalized between January 2019 and December 2020. Results: In school-aged children, the T, L, T/L, T × L, and dis-D values of patients with VVS were greater than those of patients with POTS; in adolescents, the T, T/L, T × L, and pro-D values of patients with VVS were greater than those of patients with POTS. Using a T/L cut-off value of 0.3 to distinguish between the two diseases, the sensitivity and specificity were 91.0 and 90.5%, respectively, for the total participants; 91.6 and 88.9%, respectively, for the school-aged children; and 82.1 and 95.7%, respectively, for the adolescents. In the validation study, a T/L cut-off value of 0.3 yielded an accuracy, sensitivity, and specificity of 81.8, 87.2, and 77.6%, respectively, in the total participants; 76.5, 82.6, and 71.4%, respectively, in the school-aged children; and 89.2, 93.8, and 85.7%, respectively, in the adolescents, in distinguishing VVS from POTS validated by clinical diagnosis. Conclusions: The graphic parameters of the Poincaré plot are significantly different between VVS and POTS in pediatric patients, and the T/L of the Poincaré plot may be a useful measure to help differentiate VVS from POTS in children and adolescents. SN - 2296-2360 UR - https://www.unboundmedicine.com/medline/citation/35372154/Poincaré_Plot_Is_Useful_for_Distinguishing_Vasovagal_Syncope_From_Postural_Tachycardia_Syndrome_in_Children_ DB - PRIME DP - Unbound Medicine ER -