Prognostic Value of Biomarkers in Children and Adolescents With Orthostatic Intolerance

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2021 Dec 10

PMID 34888267

Citations 2

Authors

Huijuan Yan

Shuo Wang

Hong Cai

Juan Zhang

Ping Liu

Yuwen Wang

Runmei Zou

Cheng Wang

Affiliations

Soon will be listed here.

Abstract

Orthostatic intolerance (OI) refers to a series of symptoms that occur during upright standing, which can be relieved when returned to the supine position. OI is a common cause of syncope in children and adolescents. In recent years, more and more studies have been carried out to assess the prognosis of OI by using biomarkers, among which, flow-mediated vasodilation, left ventricular ejection fraction and fractional shortening, hemodynamic change during head-up tilt test, detection of 24-h urinary sodium excretion, body mass index, midregional pro-adrenomedullin, and erythrocytic HS producing rate are relatively stable, inexpensive, and easy to obtain. With the help of biomarkers, individualized treatment can be carried out to improve the long-term prognosis of children and adolescents with OI. This article reviews the prognostic value of biomarkers in children and adolescents with OI.

Citing Articles

Guidelines for the diagnosis and treatment of neurally mediated syncope in children and adolescents (revised 2024).

Wang C, Liao Y, Wang S, Tian H, Huang M, Dong X World J Pediatr. 2024; 20(10):983-1002.

PMID: 39110332 PMC: 11502568. DOI: 10.1007/s12519-024-00819-w.

Development of prognostic nomogram model to predict syncope recurrence in children with vasovagal syncope.

Sun R, Kang Y, Zhang M, Wang H, Shi L, Li X Front Cardiovasc Med. 2023; 10:1099115.

PMID: 36970348 PMC: 10031040. DOI: 10.3389/fcvm.2023.1099115.

References

Kitamura K, Kangawa K, Kawamoto M, Ichiki Y, Nakamura S, Matsuo H . Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma. Biochem Biophys Res Commun. 1993; 192(2):553-60. DOI: 10.1006/bbrc.1993.1451. View

Yang J, Zhao J, Du S, Liu D, Fu C, Li X . Postural orthostatic tachycardia syndrome with increased erythrocytic hydrogen sulfide and response to midodrine hydrochloride. J Pediatr. 2013; 163(4):1169-73.e2. DOI: 10.1016/j.jpeds.2013.04.039. View

Zhang Q, Liao Y, Tang C, Du J, Jin H . Twenty-four-hour urinary sodium excretion and postural orthostatic tachycardia syndrome. J Pediatr. 2012; 161(2):281-4. DOI: 10.1016/j.jpeds.2012.01.054. View

Zhang F, Li X, Ochs T, Chen L, Liao Y, Tang C . Midregional pro-adrenomedullin as a predictor for therapeutic response to midodrine hydrochloride in children with postural orthostatic tachycardia syndrome. J Am Coll Cardiol. 2012; 60(4):315-20. DOI: 10.1016/j.jacc.2012.04.025. View

Grubb B . Pathophysiology and differential diagnosis of neurocardiogenic syncope. Am J Cardiol. 1999; 84(8A):3Q-9Q. DOI: 10.1016/s0002-9149(99)00691-8. View

Solbiati M, Casazza G, Dipaola F, Rusconi A, Cernuschi G, Barbic F . Syncope recurrence and mortality: a systematic review. Europace. 2014; 17(2):300-8. DOI: 10.1093/europace/euu327. View

Boris J, Bernadzikowski T . Demographics of a large paediatric Postural Orthostatic Tachycardia Syndrome Program. Cardiol Young. 2018; 28(5):668-674. DOI: 10.1017/S1047951117002888. View

Lu W, Yan H, Wu S, Chen S, Xu W, Jin H . Electrocardiography-Derived Predictors for Therapeutic Response to Treatment in Children with Postural Tachycardia Syndrome. J Pediatr. 2016; 176:128-33. DOI: 10.1016/j.jpeds.2016.05.030. View

Soteriades E, Evans J, Larson M, Chen M, Chen L, Benjamin E . Incidence and prognosis of syncope. N Engl J Med. 2002; 347(12):878-85. DOI: 10.1056/NEJMoa012407. View

10.

Kizilbash S, Ahrens S, Bruce B, Chelimsky G, Driscoll S, Harbeck-Weber C . Adolescent fatigue, POTS, and recovery: a guide for clinicians. Curr Probl Pediatr Adolesc Health Care. 2014; 44(5):108-33. PMC: 5819886. DOI: 10.1016/j.cppeds.2013.12.014. View

11.

Lin J, Liu P, Wang Y, Li H, Li X, Zhao J . [Evaluation of the changes in heart rate during head-up test predicting the efficacy of oral rehydration salts on postural tachycardia syndrome in children]. Zhonghua Er Ke Za Zhi. 2015; 53(1):25-9. View

12.

Reilly C, Floyd S, Lee K, Warwick G, James S, Gall N . Breathlessness and dysfunctional breathing in patients with postural orthostatic tachycardia syndrome (POTS): The impact of a physiotherapy intervention. Auton Neurosci. 2019; 223:102601. DOI: 10.1016/j.autneu.2019.102601. View

13.

Serletis A, Rose S, Sheldon A, Sheldon R . Vasovagal syncope in medical students and their first-degree relatives. Eur Heart J. 2006; 27(16):1965-70. DOI: 10.1093/eurheartj/ehl147. View

14.

Li H, Gao L, Yuan Y . Advance in the understanding of vasovagal syncope in children and adolescents. World J Pediatr. 2020; 17(1):58-62. DOI: 10.1007/s12519-020-00367-z. View

15.

Novak P . Autonomic Disorders. Am J Med. 2018; 132(4):420-436. DOI: 10.1016/j.amjmed.2018.09.027. View

16.

Johnson J, Mack K, Kuntz N, Brands C, Porter C, Fischer P . Postural orthostatic tachycardia syndrome: a clinical review. Pediatr Neurol. 2010; 42(2):77-85. DOI: 10.1016/j.pediatrneurol.2009.07.002. View

17.

Shen W, Sheldon R, Benditt D, Cohen M, Forman D, Goldberger Z . 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017; 136(5):e60-e122. DOI: 10.1161/CIR.0000000000000499. View

18.

Liao Y, Yang J, Zhang F, Chen S, Liu X, Zhang Q . Flow-mediated vasodilation as a predictor of therapeutic response to midodrine hydrochloride in children with postural orthostatic tachycardia syndrome. Am J Cardiol. 2013; 112(6):816-20. DOI: 10.1016/j.amjcard.2013.05.008. View

19.

Zhang Q, Du J, Zhen J, Li W, Wang Y . [Hemodynamic changes during head-up tilt test and predictive value thereof in predicting the efficacy of metoprolol therapy in children with vasovagal syncope]. Zhonghua Yi Xue Za Zhi. 2007; 87(18):1260-2. View

20.

Kenny R, Brignole M, Dan G, Deharo J, Van Dijk J, Doherty C . Syncope Unit: rationale and requirement--the European Heart Rhythm Association position statement endorsed by the Heart Rhythm Society. Europace. 2015; 17(9):1325-40. DOI: 10.1093/europace/euv115. View