Diagnostic and prognostic value of T-wave amplitude difference between supine and orthostatic electrocardiogram in children and adolescents with postural orthostatic tachycardia syndrome.

OBJECTIVE

To investigate the diagnostic and prognostic value of T-wave amplitude difference between supine and orthostatic electrocardiogram (ECG) in children and adolescents with postural orthostatic tachycardia syndrome (POTS).

METHODS

A total of 100 children and adolescents (POTS group, 50 males and 50 females, aged at 11.0 ± 2.4 years) diagnosed as POTS were enrolled from August 2013 to July 2016. Seventy-one children were matched as the control group according to age and sex. All cases completed the supine and orthostatic ECG.

RESULTS

(a) Compared with the control group, the T-wave amplitude difference in leads I, II, aVL, V , V and V and the heart rate (HR) difference increased in POTS group. (b) Logistic regression analysis: The T-wave amplitude difference in leads V , V , and V and HR difference have statistical significance for POTS diagnosis. (c) Diagnostic test evaluation: When HR difference was ≥ 15 times/min, T-wave amplitude difference in lead V was ≥0.15 mV, T-wave amplitude difference in leads V and V were ≥0.10 mV, and the sensitivity and specificity of POTS diagnosis were 35.0% and 88.7%. (d) Follow-up: There was no significant difference in HR difference and T-wave amplitude difference in the nonresponse groups. In the response group, the T-wave amplitude difference in lead V was reduced than the initial value.

CONCLUSIONS

The HR difference and T-wave amplitude difference in leads V4, V5, and V6 between supine and orthostatic ECG are of help in assisting the diagnosis of POTS but no obviously significance on prognosis estimation of it.