Zhang Wenhua, Wang Shuo, Wang Cheng, Liu Liping, Lin Ping, Li Fang, Wu Lijia, Zou Runmei
Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Institute of Pediatrics, Central South University, Changsha 410011, Hunan, China.
Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Institute of Pediatrics, Central South University, Changsha 410011, Hunan, China.
Int J Cardiol. 2016 Oct 15;221:194-7. doi: 10.1016/j.ijcard.2016.07.023. Epub 2016 Jul 5.
To investigate the familial genetic characteristics of syncope in children.
A detailed medical history was taken from four twin pairs of children complaining of dizziness, headache, chest tightness, chest pain, prodromal symptoms of syncope or syncope, meanwhile, these patients were given routine physical examination, 12-lead ECG, echocardiography, Holter ECG, EEG, MRI of the head and other tests to exclude cardio-cerebrovascular and pulmonary diseases, with those with unknown origin for syncope undergoing head-up tilt test (HUTT) and inquiry of detailed family history.
The four pairs of twins with syncope beginning at 7-12years and induced mostly by standing position (4/5), and positive family history was noted in two pairs. Vasovagal syncope (VVS)-vasoinhibitory response pattern was predominant in HUTT (4/5). The results and the response pattern in HUTT might diversify between two members within same twin pair: one appeared as vasoinhibitory response pattern and one postural orthostatic tachycardia syndrome (POTS) pattern in the first pair, one vasoinhibitory response pattern and one negative response pattern in the second pair, vasoinhibitory response pattern in the third pair and negative response pattern in the fourth pair.
The hereditary factors may play a more important role in younger children with syncope. Environment and psychological factors may induced syncope attack. The results and the response pattern in HUTT are diversified and which might different between two members within twin pair.
探讨儿童晕厥的家族遗传特征。
对四对主诉头晕、头痛、胸闷、胸痛、晕厥前驱症状或晕厥的双胞胎儿童进行详细病史采集，同时对这些患者进行常规体格检查、12导联心电图、超声心动图、动态心电图、脑电图、头颅磁共振成像等检查，以排除心脑血管和肺部疾病，对晕厥原因不明者进行直立倾斜试验（HUTT）并询问详细家族史。
四对双胞胎晕厥起病年龄为7 - 12岁，多数由站立位诱发（4/5），两对有阳性家族史。HUTT中血管迷走性晕厥（VVS）-血管抑制反应型占主导（4/5）。同一对双胞胎的两名成员HUTT结果及反应类型可能不同：第一对中一名表现为血管抑制反应型，一名表现为体位性直立性心动过速综合征（POTS）型；第二对中一名为血管抑制反应型，一名为阴性反应型；第三对为血管抑制反应型；第四对为阴性反应型。
遗传因素在年幼的晕厥儿童中可能起更重要作用。环境和心理因素可能诱发晕厥发作。HUTT结果及反应类型具有多样性，同一对双胞胎的两名成员可能不同。
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