Kovalchuk Tetiana, Boyarchuk Oksana, Balatska Nataliya
Department of Pediatrics # 2, Ivan Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine.
Department of Pediatrics and Pediatric Surgery, Ivan Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine.
Front Pediatr. 2025 Mar 11;13:1553428. doi: 10.3389/fped.2025.1553428. eCollection 2025.
The aim of the study was to assess the effectiveness of vitamin B6, B9, B12, and D3 supplements in reducing symptoms and the frequency of syncope, improving autonomic nervous system functions, and enhancing quality of life (QOL) in children following an episode of vasovagal syncope (VVS).
The study involved 68 adolescents with VVS who consistently took vitamin B and D supplements and returned for the examination after 3 months. The effectiveness of the therapy was assessed using the CSSS (Calgary Syncope Seizure Score) and MCSSS (Modified Calgary Syncope Seizure Score), serum vitamin profiles (measured using the ELISA method), heart rate variability, blood pressure variability, and the PedsQL™ (Pediatric Quality of Life Inventory™) 4.0 Generic Core Scales and PedsQL™ 2.0 Family Impact Module surveys.
The study demonstrated that 3 months of vitamin supplementation were associated with a significant reduction in the frequency of symptoms and syncope episodes ( < 0.05). A marked decrease in serum homocysteine levels was observed, from 13.8 (9.9-17.9) µmol/L to 8.5 (7.6-10.8) µmol/L ( < 0.001). Vitamin supplementation also resulted in improved heart rate variability, evidenced by a significant increase in the SDANN index ( = 0.03) and reductions in TP ( = 0.002), LF ( = 0.004), and LF/HF ( = 0.01), indicating a decrease in sympathotonic influences on the cardiovascular system. Additionally, improved cardiac autonomic function in children with VVS during therapy was reflected by a higher prevalence of dipper profiles for systolic ( = 0.008) and diastolic ( < 0.001) blood pressure. During the 3-month therapy, the QOL in children showed improvements in physical, emotional, and school functioning ( < 0.05). In parents of children with a history of VVS, there were enhancements in physical, emotional, social, and cognitive functioning, as well as in communication and a reduction in worry levels. Among family members, daily activities and family relationships also improved ( < 0.05).
The use of vitamin B6, B9, B12, and D3 supplements in therapeutic and preventive doses over 3 months in patients with a history of VVS is associated with a reduction in symptoms and syncope frequency, a decrease in serum homocysteine levels, a reduction in autonomic dysregulation, and an improvement in the QOL for children and their families.
本研究旨在评估维生素B6、B9、B12和D3补充剂在减轻血管迷走性晕厥(VVS)发作后儿童的症状和晕厥频率、改善自主神经系统功能以及提高生活质量(QOL)方面的有效性。
该研究纳入了68名患有VVS的青少年,他们持续服用维生素B和D补充剂,并在3个月后返回接受检查。使用卡尔加里晕厥发作评分(CSSS)和改良卡尔加里晕厥发作评分(MCSSS)、血清维生素谱(采用ELISA法测量)、心率变异性、血压变异性以及儿童生活质量量表(PedsQL™)4.0通用核心量表和PedsQL™ 2.0家庭影响模块调查问卷来评估治疗效果。
研究表明,3个月的维生素补充与症状和晕厥发作频率的显著降低相关(<0.05)。观察到血清同型半胱氨酸水平显著下降,从13.8(9.9 - 17.9)µmol/L降至8.5(7.6 - 10.8)µmol/L(<0.001)。维生素补充还导致心率变异性得到改善,表现为SDANN指数显著增加(=0.03)以及总功率(TP,=0.002)、低频功率(LF,=0.004)和低频/高频功率比值(LF/HF,=0.01)降低,这表明交感神经对心血管系统的影响减弱。此外,VVS患儿在治疗期间心脏自主功能的改善表现为收缩压(=0.008)和舒张压(<0.001)勺型血压模式的患病率更高。在3个月的治疗期间,儿童的生活质量在身体、情感和学校功能方面有所改善(<0.05)。对于有VVS病史儿童的家长,其身体、情感、社交和认知功能以及沟通能力都有所增强,担忧程度降低。在家庭成员中,日常活动和家庭关系也得到改善(<0.05)。
有VVS病史的患者连续3个月使用治疗和预防剂量的维生素B6、B9、B12和D3补充剂,与症状和晕厥频率降低、血清同型半胱氨酸水平下降、自主神经调节异常减轻以及儿童及其家庭生活质量改善相关。