Can pediatric vasovagal syncope be individually managed?

Xu, Wenrui; Du, Junbao; Jin, Hongfang

doi:10.1007/s12519-021-00495-0

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…For instance, ORS might be considered for those with insufficient blood volume ( 29 , 30 ), metoprolol for those with increased sympathetic activity and high catecholamines ( 31 ), and midodrine for those with excessive vasodilation, in their main mechanisms, respectively ( 32 ). The pathogenesis of patients with NMS is diverse ( 33 ); therefore, NMS treatments should require an individualized evaluation by pediatricians ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Spectrum of underlying diseases in syncope and treatment of neurally-mediated syncope in children and adolescents over the past 30 years: A single center study

Cui

Liao²,

Zhang³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSyncope is the primary cause of transient loss of consciousness, which causes severe physical and mental burdens to children and adolescents.ObjectiveThe study was designed to analyze the spectrum of underlying diseases of syncope and treatment options for neurally-mediated syncope (NMS) in Chinese children and adolescents.MethodsMedical records including history, physical examination, blood biochemistry, standing test, head-up tilt (HUTT), sitting-up test, electroencephalogram (EEG), electrocardiogram (ECG), and echocardiography were retrospectively studied in children and adolescents admitted to the National Pediatric Syncope Center, Department of Pediatrics, Peking University First Hospital between 1992 and 2021. All the data were collected from the Beijing Kaihua Medical Management System (Kaihua, Beijing, China). Children who met the syncope diagnostic criteria were enrolled in the study. The spectrum of the underlying diseases of syncope in children and adolescents and the treatment options of NMS were analyzed.ResultsA total of 1,947 children and adolescents with syncope were admitted, including 869 males (44.63%) and 1,078 females (55.37%) aged 1–18 years, with an average age of 11.1 ± 3.1 years. The number of children and adolescents with syncope displayed a gradually increasing trend between 1992 and 2021 except after 2020. NMS proportion increased, and the proportion of unexplained syncope decreased (χ2 = 128.839, P < 0.01). The treatment options of NMS mainly included autonomic nervous function exercise (549, 34.46%), oral rehydration salt (ORS; 445, 27.94%), metoprolol (219, 13.75%), midodrine (120, 7.53%), ORS plus metoprolol (139, 8.73%), ORS plus midodrine (120, 7.53%), and pacemakers (1, 0.06%). Patients with vasovagal syncope (VVS) coexisting with postural orthostatic tachycardia syndrome (POTS) were more likely to take pharmacological treatments than those with VVS or POTS only (χ2 = 41.696, P < 0.01).ConclusionThe number of children with syncope displayed an increasing trend before 2020, and the proportion of unexplained syncope decreased. Autonomic nervous function exercise was the most common treatment for children and adolescents with NMS. Children with VVS coexisting with POTS were more likely to receive pharmacological treatments than those with either.

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Section: Discussionmentioning

confidence: 99%

Spectrum of underlying diseases in syncope and treatment of neurally-mediated syncope in children and adolescents over the past 30 years: A single center study

Cui

Liao²,

Zhang³

et al. 2022

Front. Cardiovasc. Med.

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show abstract

“…Indeed, syncope sometimes starts with a period of excessive increase in HR and myocardial contractility, which can be detected immediately before the occurrence of syncope by echocardiography [33]. As a result, traditional ideas have stated that an overactivated sympathetic nervous system is one of the important mechanisms causing VVS [34]. However, as arterial pressure, cerebral blood flow, and brainstem perfusion all decrease, a pattern of progressive baroreflex dysfunction becomes apparent.…”

Section: Baroreflex Sensitivity In Patients With Neurally Mediated Sy...mentioning

confidence: 99%

Baroreflex sensitivity and its implication in neurally mediated syncope in children

Cui

Jin

2023

World J Pediatr

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“…The physical and mental health of children with VVS is often affected ( 2 , 3 ). In recent years, ample research has been conducted on individualized treatment of children with VVS ( 4 ). Currently, known therapeutic methods of VVS include pharmacological and non-pharmacological therapies.…”

Section: Introductionmentioning

confidence: 99%

Markers for predicting the efficacy of beta-blockers in vasovagal syncope management in children: A mini-review

Wang

Liu²,

Jin³

et al. 2023

Front. Cardiovasc. Med.

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Vasovagal syncope (VVS) is a common subtype of neurally mediated syncope. It is prevalent in children and adolescents, and critically affects the quality of life of patients. In recent years, the management of pediatric patients with VVS has received extensive attention, and β-blocker serves as an important choice of the drug therapy for children with VVS. However, the empirical use of β-blocker treatment has limited therapeutic efficacy in patients with VVS. Therefore, predicting the efficacy of β-blocker therapy based on biomarkers related to the pathophysiological mechanism is essential, and great progress has been made by applying these biomarkers in formulating individualized treatment plans for children with VVS. This review summarizes recent advances in predicting the effect of β-blockers in the management of VVS in children.

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Can pediatric vasovagal syncope be individually managed?

Cited by 10 publications

References 14 publications

Spectrum of underlying diseases in syncope and treatment of neurally-mediated syncope in children and adolescents over the past 30 years: A single center study

Spectrum of underlying diseases in syncope and treatment of neurally-mediated syncope in children and adolescents over the past 30 years: A single center study

Baroreflex sensitivity and its implication in neurally mediated syncope in children

Markers for predicting the efficacy of beta-blockers in vasovagal syncope management in children: A mini-review

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