Cao Yali, Liu Ping, Li Bo, Zhang Yingqian, Du Junbao, Jin Hongfang, Liao Ying
Department of Pediatrics, Children's Medical Center, Peking University First Hospital, Beijing 102627, China.
Department of Cardiology, Children' Hospital of Hebei Province, Shijiazhuang 050031, China.
Children (Basel). 2025 Apr 7;12(4):474. doi: 10.3390/children12040474.
The current study aims to investigate the factors associated with the severity of conditions for pediatric cases with postural orthostatic tachycardia syndrome (POTS). Patients hospitalized and first diagnosed with POTS were retrospectively included and reviewed. The severity of symptoms was evaluated by symptom scores (SSs). Multiple Spearman correlation analyses and multiple linear regression analyses were used to determine factors independently associated with SS. Patients were divided into the mild (SS ≤ P25) and severe (SS ≥ P75) groups to test the distinguishing efficiency of the candidate factors. The efficiency of each independently correlated factor in indicating the condition of children with POTS was assessed by the receiver operating characteristic (ROC) curve. A series of 296 pediatric patients aged 5-17 years suffering from POTS were included. Multiple Spearman correlation analyses and multiple linear regression analyses showed that corrected QT interval dispersion (QTcd) was independently correlated with SS ( < 0.05). QTcd can be used to suggest the severity of POTS symptoms, and the area under the curve (AUC) was 0.986 (95% CI 0.976-0.997). At a threshold of QTcd = 45 ms, the sensitivity and specificity were, respectively, 94.0% and 91.8% for symptom severity indication. In pediatric cases with POTS, QTcd was positively correlated with their symptom severity and exhibited a strong indicative value. A QTcd of 45 ms was a valid cut-off value for indicating symptom severity.
本研究旨在调查与体位性直立性心动过速综合征（POTS）儿科病例病情严重程度相关的因素。回顾性纳入并分析首次诊断为POTS并住院的患者。通过症状评分（SS）评估症状严重程度。采用多重Spearman相关性分析和多重线性回归分析来确定与SS独立相关的因素。将患者分为轻度（SS≤P25）和重度（SS≥P75）组，以测试候选因素的区分效率。通过受试者工作特征（ROC）曲线评估每个独立相关因素指示POTS患儿病情的效率。共纳入296例年龄在5 - 17岁的POTS儿科患者。多重Spearman相关性分析和多重线性回归分析表明，校正QT间期离散度（QTcd）与SS独立相关（<0.05）。QTcd可用于提示POTS症状的严重程度，曲线下面积（AUC）为0.986（95%CI 0.976 - 0.997）。在QTcd = 45 ms的阈值下，症状严重程度指示的敏感性和特异性分别为94.0%和91.8%。在POTS儿科病例中，QTcd与症状严重程度呈正相关，并具有较强的指示价值。QTcd为45 ms是指示症状严重程度的有效截断值。
