Heart Rate Variability Predicts Therapeutic Response to Metoprolol in Children With Postural Tachycardia Syndrome

Wang, Yuanyuan; Zhang, Chunyu; Chen, Selena; Liu, Ping; Wang, Yuli; Tang, Chaoshu; Jin, Hongfang; Du, Junbao

doi:10.3389/fnins.2019.01214

Cited by 21 publications

(34 citation statements)

References 40 publications

(36 reference statements)

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“… 70 , 134 , 135 ) and are extensively used in HRV studies across topics (e.g. 136 - 138 ), they also suffer from limitations (e.g. 89 , 94 ) which have been addressed in the Discussion.…”

Section: Methodsmentioning

confidence: 99%

Autonomic function in amnestic and non-amnestic mild cognitive impairment: spectral heart rate variability analysis provides evidence for a brain–heart axis

Nicolini

Mari

Abbate

et al. 2020

Sci Rep

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Mild cognitive impairment (Mci) is a heterogeneous syndrome with two main clinical subtypes, amnestic (aMci) and non-amnestic (naMci). the analysis of heart rate variability (HRV) is a tool to assess autonomic function. cognitive and autonomic processes are linked via the central autonomic network. Autonomic dysfunction entails several adverse outcomes. However, very few studies have investigated autonomic function in Mci and none have considered Mci subtypes or the relationship of HRV indices with different cognitive domains and structural brain damage. We assessed autonomic function during an active orthostatic challenge in 253 oupatients aged ≥ 65, [n = 82 aMCI, n = 93 naMCI, n = 78 cognitively normal (CN), neuropsychologically tested] with power spectral analysis of HRV. We used visual rating scales to grade cerebrovascular burden and hippocampal/insular atrophy (HA/iA) on neuroimaging. only aMci showed a blunted response to orthostasis. postural changes in normalised low frequency (Lf) power and in the Lf to high frequency ratio correlated with a memory test (positively) and HA/iA (negatively) in aMci, and with attention/executive function tests (negatively) and cerebrovascular burden (positively) in naMci. these results substantiate the view that the AnS is differentially impaired in aMCI and naMCI, consistently with the neuroanatomic substrate of Alzheimer's and small-vessel subcortical ischaemic disease.

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“… 70 , 134 , 135 ) and are extensively used in HRV studies across topics (e.g. 136 - 138 ), they also suffer from limitations (e.g. 89 , 94 ) which have been addressed in the Discussion.…”

Section: Methodsmentioning

confidence: 99%

Autonomic function in amnestic and non-amnestic mild cognitive impairment: spectral heart rate variability analysis provides evidence for a brain–heart axis

Nicolini

Mari

Abbate

et al. 2020

Sci Rep

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“…Interfering signals were automatically excluded by the standardized QRS peak detection of the analysis system. The time domain parameters, including standard deviations for all NN heart rate intervals over 24 h (SDNN), the standard deviation of the averages of NN intervals calculated over 5-min periods of the entire recording (SDANN), percentage of differences between adjacent RR intervals that are >50 ms (PNN50), and square root of mean squared differences of successive NN intervals (rMSSD) were analyzed (Wang et al, 2019).…”

Section: Heart Rate Variability (Hrv)mentioning

confidence: 99%

Vitamin D Deficiency in Children With Vasovagal Syncope Is Associated With Impaired Circadian Rhythm of Blood Pressure

et al. 2021

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BackgroundVitamin D deficiency is associated with the risk of cardiovascular diseases. We aimed to investigate the serum vitamin D levels in children with vasovagal syncope (VVS) and explore the correlation of vitamin D status and circadian rhythm of blood pressure in VVS pediatric patients.MethodsThis was a retrospective study. 130 syncopal children diagnosed with VVS were included in the study. 110 age and gender matched healthy individuals were enrolled as control. According to serum 25(OH)D levels, VVS patients were divided into vitamin D sufficient group and vitamin D deficient group. Detailed information of VVS children with vitamin D deficiency and sufficiency on demographic data, baseline laboratory testing, echocardiogram, ambulatory blood pressure monitoring, and Holter ECG recording were extracted and analyzed.ResultsVVS children had a higher prevalence of vitamin D deficiency compared with healthy individuals (33.8% vs. 20.0%, P = 0.017). VVS patients with vitamin D deficiency had a higher rate of non-dipper blood pressure (79.5% vs. 59.3%, P = 0.021) and a lower value of square root of mean squared differences of successive normal to normal intervals (rMSSD) (median 107.8 vs. 141.0 ms, P = 0.035) compared with those with vitamin D sufficiency. Logistic regression analysis showed that non-dipper blood pressure was associated with serum 25(OH)D level [OR = 0.979, 95% CI (0.960, 0.999), P = 0.036].ConclusionVVS pediatric patients had a higher prevalence of vitamin D deficiency. VVS children with vitamin D deficiency showed a higher rate of non-dipper blood pressure, suggesting that vitamin D deficiency is correlated with impaired circadian rhythm of blood pressure.

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“…Similarly, the orthostatic intolerance symptom score may be applied to evaluation of therapeutic effect. Li et al 33 and Wang et al 34 used a symptom score to evaluate the therapeutic effect of postural tachycardia syndrome. The symptoms included fainting, dizziness, chest discomfort, nausea, palpitations, headache, blurred vision, hand trembling, and cold sweat.…”

Section: Discussionmentioning

confidence: 99%

Symptom Score: A New Instrument to Assess Orthostatic Intolerance in Children and Adolescents

et al. 2020

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Objective: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. Methods: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. Results: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min ( P < .01). Conclusions: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.

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Heart Rate Variability Predicts Therapeutic Response to Metoprolol in Children With Postural Tachycardia Syndrome

Cited by 21 publications

References 40 publications

Autonomic function in amnestic and non-amnestic mild cognitive impairment: spectral heart rate variability analysis provides evidence for a brain–heart axis

Autonomic function in amnestic and non-amnestic mild cognitive impairment: spectral heart rate variability analysis provides evidence for a brain–heart axis

Vitamin D Deficiency in Children With Vasovagal Syncope Is Associated With Impaired Circadian Rhythm of Blood Pressure

Symptom Score: A New Instrument to Assess Orthostatic Intolerance in Children and Adolescents

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