Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Department of Pediatrics, Children's Hospital of Kaifeng, Henan 475000, China.
Chin Med J (Engl). 2021 Aug 12;134(16):1977-1982. doi: 10.1097/CM9.0000000000001698.
Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient's physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS.
This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of <0.100 in the univariate analyses and the demographic characteristics.
A comparison of responders and non-responders revealed no significant differences in demographic, hemodynamic characteristics, and urine specific gravity (all P > 0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013).
Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.
体位性心动过速综合征（POTS）是一种常见的儿科疾病，严重影响患者的身心健康。本研究旨在探讨儿童和青少年 POTS 患者在接受美托洛尔治疗前的左心室射血分数（LVEF）和左心室短轴缩短率（LVFS）基线值是否与症状改善相关。
本回顾性研究纳入了 2010 年 11 月至 2019 年 7 月期间在北京大学第一医院接受美托洛尔治疗的 51 例 POTS 患儿和青少年。所有患者在治疗前均完成直立试验或基础头高位倾斜试验及心脏超声心动图检查。治疗 3 个月后评估治疗反应。评估治疗前基线 LVEF 和 LVFS 值与治疗后症状评分下降（ΔSS）的相关性。多变量分析采用单因素分析中 P 值<0.100 的因素和人口统计学特征。
比较应答者和无应答者，两组间在人口统计学、血流动力学特征和尿比重（均 P>0.050）方面无显著差异。然而，应答者的基线 LVEF（71.09%±4.44%比 67.17%±4.88%，t=-2.789，P=0.008）和 LVFS 值（40.00[38.00，42.00]%比 36.79%±4.11%，Z=-2.542，P=0.010）显著更高。基线 LVEF 和 LVFS 与ΔSS 呈正相关（r=0.378，P=0.006；r=0.363，P=0.009）。Logistic 回归分析显示，LVEF 与儿童和青少年 POTS 患者对美托洛尔治疗的反应独立相关（比值比：1.201，95%置信区间：1.039-1.387，P=0.013）。
儿童和青少年 POTS 患者在接受美托洛尔治疗前的 LVEF 与症状改善相关。
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