Biomarkers and Hemodynamic Parameters in the Diagnosis and Treatment of Children with Postural Tachycardia Syndrome and Vasovagal Syncope

Cheng, Wenjie; Wang, Jiaqi; Lin, Jing

doi:10.3390/ijerph19126974

Cited by 3 publications

(4 citation statements)

References 100 publications

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“…Therefore, further enhancing the clinical therapeutic efficacy of POTS is currently a crucial clinical concern in the field. Thus, searching for stable, easy-to-use, and inexpensive biomarkers to predict the treatment response to different medications for patients with POTS has become a hot point in clinical research [11,51]. As such, further exploring clinical biomarkers for predicting the efficacy of the treatment of POTS and implementing individualized therapy have significant importance in improving the clinical outcomes of the patients.…”

Section: Individualized Pharmacologic Therapies For Pediatric Pots: P...mentioning

confidence: 99%

“…POTS in children can result from several pathophysiological mechanisms, including peripheral vascular dysfunction, hypovolemia, autonomic dysfunction, a hyperadrenergic state, impaired skeletal-muscle pump activity, and autoimmune dysfunction [8][9][10]. Individualized treatments based on the different pathophysiological mechanisms underlying POTS holds greater promise than traditional empirical approaches [11]. This review indicates the latest advances in baseline hemodynamic parameters and biological indicators that can predict the clinical efficacy of POTS and provides an additional avenue for further exploration and inquiry into this syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review

et al. 2023

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Postural orthostatic tachycardia syndrome (POTS) is common in children, with an excessive increment in heart rate when moving from the supine to upright position. It has significant negative impacts on the daily life of pediatric patients. The pathogenesis of POTS includes peripheral vascular dysfunction, central hypovolemia, abnormal autonomic function, a high-adrenergic state, impaired skeletal-muscle pump function, the abnormal release of vasoactive factors, and autoimmune abnormalities. Therefore, the empirical use of pharmacological treatments has limited therapeutic efficacy due to the diversity of its mechanisms. A crucial aspect of managing POTS is the selection of appropriate treatment targeting the specific pathogenesis. This review summarizes the commonly used pharmacological interventions, with a focus on their predictive indicators for treatment response. Factors such as heart rate variability, plasma biomarkers, and cardiac-function parameters are discussed as potential predictors of therapeutic efficacy, enabling the implementation of individualized treatment to improve therapeutic effectiveness. This review consolidates the current knowledge on POTS, encompassing its clinical characteristics, epidemiological patterns, underlying pathogenic mechanisms, and predictive indicators for treatment response. Further research is warranted to enhance the understanding of POTS and facilitate the development of more effective therapeutic approaches for this challenging syndrome.

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Section: Individualized Pharmacologic Therapies For Pediatric Pots: P...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review

et al. 2023

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“…No entanto, Wieling et al relataram sete casos adultos com hipotensão prolongada pós-síncope (HPPS). 14 Apesar do uso de nitrato sublingual nesses casos, o autor argumenta que o mecanismo de HPPS demonstrou ser a recuperação retardada de VS e CO devido à diminuição da contratilidade cardíaca, e não à vasodilatação mediada pela retirada simpática vascular. 15 …”

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“…This suggests that BMI is related to blood volume. 17 On the other hand, vasovagal syncope occurs more commonly with taller individuals, which is justified by the importance of height (h) in gravitational stress. 2 The direction of the Earth's gravitational field close to the surface is vertical, and the distance r is equal to the system height: Ugr=gz x h. That explains why the effect of gravity is significant only in the orthostatic posture.…”

mentioning

confidence: 99%

Que Peças Faltam no Quebra-Cabeça da Adaptação Cardiovascular ao Ortostatismo?

Elias¹

2023

Arquivos Brasileiros De Cardiologia

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Guidelines for the diagnosis and treatment of neurally mediated syncope in children and adolescents (revised 2024)

Wang,

Liao,

Wang

et al. 2024

World J Pediatr

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Background Significant progress has been made in the diagnosis and treatment of pediatric syncope since the publication of the “2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents” (“2018 Edition Guidelines”). Therefore, we have revised and updated it to assist pediatricians in effectively managing children with syncope. Data sources According to the “2018 Edition Guidelines”, the expert groups collected clinical evidence, evaluated preliminary recommendations, and then organized open-ended discussions to form the recommendations. This guideline was developed by reviewing the literature and studies in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to April 2024. Search terms included “syncope”, “children”, “adolescents”, “diagnosis”, and “treatment.” Results The guidelines were based on the latest global research progress and were evidence-based. The classification of syncope etiology, diagnostic procedures, postural tests, such as the active standing test, head-up tilt test, and active sitting test, clinical diagnosis, and individualized treatment for neurally mediated syncope in pediatric population were included. Conclusions The guidelines were updated based on the latest literature. The concepts of sitting tachycardia syndrome and sitting hypertension were introduced and the comorbidities of neurally mediated syncope were emphasized. Some biomarkers used for individualized treatment were underlined. Specific suggestions were put forward for non-pharmacological therapies as well as the follow-up process. The new guidelines will provide comprehensive guidance and reference for the diagnosis and treatment of neurally mediated syncope in children and adolescents.

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Biomarkers and Hemodynamic Parameters in the Diagnosis and Treatment of Children with Postural Tachycardia Syndrome and Vasovagal Syncope

Cited by 3 publications

References 100 publications

Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review

Predicting Therapeutic Efficacy of Pharmacological Treatments in Children with Postural Orthostatic Tachycardia Syndrome: A Mini-Review

Que Peças Faltam no Quebra-Cabeça da Adaptação Cardiovascular ao Ortostatismo?

Guidelines for the diagnosis and treatment of neurally mediated syncope in children and adolescents (revised 2024)

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