Hongxia Li1, Zhenhui Han2, Siyao Chen1, Ying Liao1, Yuli Wang1, Ping Liu1, Yonghong Chen1, Chaoshu Tang3, Jing Lin1, Junbao Du4, Hongfang Jin5. 1. Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China. 2. Kaifeng Children's Hospital, Henan, China. 3. Kaifeng Children's Hospital, Henan, China; Department of Physiology and Pathophysiology, Peking University Health Sciences Centre, Beijing, P. R. China. 4. Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China; Key Laboratory of Cardiovascular Sciences, Ministry of Education, Beijing, P. R. China. 5. Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China. Electronic address: jinhongfang51@126.com.
Abstract
OBJECTIVE: To investigate the total peripheral vascular resistance (TPVR), cardiac output (CO), and plasma C-type natriuretic peptide (CNP) levels in children with postural tachycardia syndrome (POTS) during supine, upright, and return to supine. STUDY DESIGN: Twenty-nine children with POTS, aged 12 ± 3 years, were recruited, and 32 healthy children, aged 11 ± 2 years, served as controls. Heart rate (HR), blood pressure, TPVR, and CO were continuously monitored with Finapres Medical System, and plasma CNP levels were detected with Sandwich immunoluminescence assay. RESULTS: In children with POTS, upright TPVR and CO were significantly lower than those in supine position, and they rose again when they returned to supine position. However, in healthy control patients, both TPVR and CO did not change during supine, upright, and supine again positions. Also, in the supine position, there was no significant difference in TPVR and CO between POTS children and control subjects (P > .05). When upright, however, TPVR and CO in children with POTS were significantly lower than those of controls. Plasma CNP levels were significantly greater in children with POTS than that of controls (32.8 ± 9.7 vs 24.2 ± 8.4 [pg/mL], P < .01), and symptom scores and ΔHR positively correlated with plasma CNP levels in children with POTS (symptom scores: r = 0.490, P < .01; ΔHR: r = 0.508, P < .001), but CO negatively correlated with plasma CNP levels (r = -0.446, P < .01). CONCLUSION: Reduced TPVR and CO associated with the elevated plasma CNP might be involved in the pathogenesis of POTS.
OBJECTIVE: To investigate the total peripheral vascular resistance (TPVR), cardiac output (CO), and plasma C-type natriuretic peptide (CNP) levels in children with postural tachycardia syndrome (POTS) during supine, upright, and return to supine. STUDY DESIGN: Twenty-nine children with POTS, aged 12 ± 3 years, were recruited, and 32 healthy children, aged 11 ± 2 years, served as controls. Heart rate (HR), blood pressure, TPVR, and CO were continuously monitored with Finapres Medical System, and plasma CNP levels were detected with Sandwich immunoluminescence assay. RESULTS: In children with POTS, upright TPVR and CO were significantly lower than those in supine position, and they rose again when they returned to supine position. However, in healthy control patients, both TPVR and CO did not change during supine, upright, and supine again positions. Also, in the supine position, there was no significant difference in TPVR and CO between POTS children and control subjects (P > .05). When upright, however, TPVR and CO in children with POTS were significantly lower than those of controls. Plasma CNP levels were significantly greater in children with POTS than that of controls (32.8 ± 9.7 vs 24.2 ± 8.4 [pg/mL], P < .01), and symptom scores and ΔHR positively correlated with plasma CNP levels in children with POTS (symptom scores: r = 0.490, P < .01; ΔHR: r = 0.508, P < .001), but CO negatively correlated with plasma CNP levels (r = -0.446, P < .01). CONCLUSION: Reduced TPVR and CO associated with the elevated plasma CNP might be involved in the pathogenesis of POTS.
Authors: Julian M Stewart; Paul Pianosi; Mohamed A Shaban; Courtney Terilli; Maria Svistunova; Paul Visintainer; Marvin S Medow Journal: J Appl Physiol (1985) Date: 2018-08-23
Authors: Julian M Stewart; Paul Pianosi; Mohamed A Shaban; Courtney Terilli; Maria Svistunova; Paul Visintainer; Marvin S Medow Journal: J Am Heart Assoc Date: 2018-06-30 Impact factor: 5.501