Tao Chunyan, Xu Bowen, Liao Ying, Li Xueying, Jin Hongfang, Du Junbao
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Front Pediatr. 2022 Apr 8;10:870939. doi: 10.3389/fped.2022.870939. eCollection 2022.
To explore the predictors for syncopal recurrence in a pediatric population with vasovagal syncope (VVS) treated with metoprolol.
This study was conducted retrospectively among children suffering from VVS with or without syncopal recurrence. Data on the detailed medical history and auxiliary examinations were obtained from the electronic medical records. The risk factors for syncopal recurrence were studied by cox regression analyses and the corresponding best cutoff values were determined using receiver operating characteristic analysis. Kaplan-Meier curves were plotted to determine the trends of the syncopal recurrence-free survival rate.
Forty-two consecutive VVS children were enrolled in the study. At the end of a median follow-up duration of 9.0 (4.8, 19.1) months, 12 patients (29%) experienced ≥1 syncopal episode. Cox regression analyses revealed that the number of previous syncopal episodes before treatment was a risk factor for syncopal recurrence (hazard ratio = 1.027, 95% confidence interval 1.009 - 1.045, = 0.003). Moreover, 4 previous syncopal episodes were certified as the best cutoff value, and the Kaplan-Meier curves showed that the syncopal recurrence-free survival rate over time in patients with > 4 previous syncopal episodes was significantly lower than that in patients with ≤4 episodes ( = 0.019 at the log-rank test).
In a pediatric population with VVS while on the treatment of metoprolol, the number of previous syncopal episodes before treatment played a significant role in predicting syncopal recurrence.
探讨用美托洛尔治疗的小儿血管迷走性晕厥（VVS）患者晕厥复发的预测因素。
本研究对有或无晕厥复发的VVS患儿进行回顾性研究。从电子病历中获取详细病史和辅助检查数据。通过Cox回归分析研究晕厥复发的危险因素，并使用受试者工作特征分析确定相应的最佳截断值。绘制Kaplan-Meier曲线以确定无晕厥复发生存率的趋势。
连续42例VVS患儿纳入研究。在中位随访时间9.0（4.8，19.1）个月结束时，12例患者（29%）经历了≥1次晕厥发作。Cox回归分析显示，治疗前晕厥发作次数是晕厥复发的危险因素（风险比=1.027，95%置信区间1.009 - 1.045，P = 0.003）。此外，4次既往晕厥发作被确认为最佳截断值，Kaplan-Meier曲线显示，既往晕厥发作次数>4次的患者随时间的无晕厥复发生存率显著低于≤4次的患者（对数秩检验P = 0.019）。
在接受美托洛尔治疗的小儿VVS患者中，治疗前晕厥发作次数对预测晕厥复发起重要作用。
