Background： Vasovagal syncope （VVS） is the most common cause of syncope in children. Neuropeptide Y （NPY） plays an important role in the regulation of blood pressure （BP）, as well as myocardial contractility. T...Background： Vasovagal syncope （VVS） is the most common cause of syncope in children. Neuropeptide Y （NPY） plays an important role in the regulation of blood pressure （BP）, as well as myocardial contractility. This study aimed to explore the role of plasma NPY in VVS in children. Methods： Fifty-six children who were diagnosed with VVS （VVS group） using head-up tilt test （HUT） and 31 healthy children who were selected as controls （control group） were enrolled. Plasma NPY concentrations were detected. The independent t-test was used to compare the data of the VVS group with those of the control group. The changes in plasma NPY levels in the VVS group during the HUT, as well as hemodynamic parameters, such as heart rate （HR）, BP, total peripheral vascular resistance （TPVR）, and cardiac output （CO）, were evaluated using the paired t-test. Furthermore, the correlations between plasma NPY levels and hemodynamic parameters were analyzed using bivariate correlation analysis. Results： The BP, HR, and plasma NPY （0.34 ± 0.12 pg/ml vs. 0.46 ± 0.13 pg/ml） levels in the supine position were statistically low in the VVS group compared to levels in the control group （all P 〈 0.05）. Plasma NPY levels were positively correlated with the HR （Pearson, R = 0.395, P 〈 0.001） and diastolic BP （Pearson, R = 0.311, P = 0.003） when patients were in the supine position. When patients in the VVS group were in the supine position, elevated TPVR （4.6 ± 3.7 mmHg·min-1·L-1 vs. 2.5 ± 1.0 mmHg·min-1·L-1, respectively, P 〈 0.001;1 mmHg = 0.133 kPa） and reduced CO （1.0 ± 0.7 L/min vs. 2.4 ± 1.3 L/min, respectively, P 〈 0.001） were observed in the positive-response period compared with baseline values. The plasma NPY levels were positively correlated with TPVR （Spearman, R = 0.294, P = 0.028） but negatively correlated with CO in the positive-response period during HUT （Spearman, R = -0.318, P = 0.017）. Conclusions： Plasma NPY may contribute to the pathogenesis of VVS by increasing the TPVR and decreasing the CO during orthostatic regulation.展开更多
目的:分析体位性心动过速综合征(postural tachycardia syndrome, POTS)儿童及青少年直立试验过程中血流动力学变化及不同心脏指数(cardiac index, CI)患者血流动力学指标的差异。方法:回顾性分析26例POTS患者与12例健康对照者间直立试...目的:分析体位性心动过速综合征(postural tachycardia syndrome, POTS)儿童及青少年直立试验过程中血流动力学变化及不同心脏指数(cardiac index, CI)患者血流动力学指标的差异。方法:回顾性分析26例POTS患者与12例健康对照者间直立试验过程中总外周血管阻力指数(total peripheral vascular resistance index, TPVRI)、心率和血压的变化,并比较两组间各指标变化趋势。根据每位POTS患者直立试验过程中CI变化趋势将患者分为CI降低组(14例)与CI未降低组(12例),分析两组患者在直立试验过程中CI、TPVRI、心率、血压变化,并比较两组间各指标变化趋势。结果: POTS患者在直立试验过程中CI显著下降( F =6.936, P =0.001),心率明显增快( F = 113.926 , P <0.001),收缩压明显降低( F =6.049, P <0.001),而TPVRI ( F =2.031, P =0.138)和舒张压( F =2.018, P =0.113)无明显变化。健康对照组CI在直立后显著升高( F =3.646, P =0.016),同时心率明显增快( F = 43.970, P <0.001),收缩压( F =4.043, P =0.020)和舒张压( F =8.627, P <0.001)均明显升高,TPVRI ( F = 1.688, P =0.190)无明显变化。POTS患者与健康对照组比较,CI ( F =6.221, P= 0.001)、心率( F =6.203, P < 0.001)和收缩压( F =7.946, P <0.001)随时间变化趋势显著不同,而TPVRI和舒张压在两组间的变化趋势差异无统计学意义( P >0.05)。CI降低组与CI未降低组POTS患者在直立试验中CI变化趋势差异有统计学意义( F = 14.723, P <0.001),前者直立后收缩压明显降低( F =8.010, P <0.001),而后者却无明显变化( F =0.612, P = 0.639 ), TPVRI、心率和舒张压在CI降低组与CI未降低组间随时间变化趋势差异无统计学意义( P >0.05)。年龄是POTS患者直立后CI呈下降趋势的独立影响因素( P =0.013, OR =2.233;95% CI :1.183~4.216)。结论: POTS患者在直立试验过程中存在明显的血流动力学变化,不同患者心输出量变化可能不同,年龄是心输出量下降的独立影响因素。展开更多
文摘Background： Vasovagal syncope （VVS） is the most common cause of syncope in children. Neuropeptide Y （NPY） plays an important role in the regulation of blood pressure （BP）, as well as myocardial contractility. This study aimed to explore the role of plasma NPY in VVS in children. Methods： Fifty-six children who were diagnosed with VVS （VVS group） using head-up tilt test （HUT） and 31 healthy children who were selected as controls （control group） were enrolled. Plasma NPY concentrations were detected. The independent t-test was used to compare the data of the VVS group with those of the control group. The changes in plasma NPY levels in the VVS group during the HUT, as well as hemodynamic parameters, such as heart rate （HR）, BP, total peripheral vascular resistance （TPVR）, and cardiac output （CO）, were evaluated using the paired t-test. Furthermore, the correlations between plasma NPY levels and hemodynamic parameters were analyzed using bivariate correlation analysis. Results： The BP, HR, and plasma NPY （0.34 ± 0.12 pg/ml vs. 0.46 ± 0.13 pg/ml） levels in the supine position were statistically low in the VVS group compared to levels in the control group （all P 〈 0.05）. Plasma NPY levels were positively correlated with the HR （Pearson, R = 0.395, P 〈 0.001） and diastolic BP （Pearson, R = 0.311, P = 0.003） when patients were in the supine position. When patients in the VVS group were in the supine position, elevated TPVR （4.6 ± 3.7 mmHg·min-1·L-1 vs. 2.5 ± 1.0 mmHg·min-1·L-1, respectively, P 〈 0.001;1 mmHg = 0.133 kPa） and reduced CO （1.0 ± 0.7 L/min vs. 2.4 ± 1.3 L/min, respectively, P 〈 0.001） were observed in the positive-response period compared with baseline values. The plasma NPY levels were positively correlated with TPVR （Spearman, R = 0.294, P = 0.028） but negatively correlated with CO in the positive-response period during HUT （Spearman, R = -0.318, P = 0.017）. Conclusions： Plasma NPY may contribute to the pathogenesis of VVS by increasing the TPVR and decreasing the CO during orthostatic regulation.
文摘目的:分析体位性心动过速综合征(postural tachycardia syndrome, POTS)儿童及青少年直立试验过程中血流动力学变化及不同心脏指数(cardiac index, CI)患者血流动力学指标的差异。方法:回顾性分析26例POTS患者与12例健康对照者间直立试验过程中总外周血管阻力指数(total peripheral vascular resistance index, TPVRI)、心率和血压的变化,并比较两组间各指标变化趋势。根据每位POTS患者直立试验过程中CI变化趋势将患者分为CI降低组(14例)与CI未降低组(12例),分析两组患者在直立试验过程中CI、TPVRI、心率、血压变化,并比较两组间各指标变化趋势。结果: POTS患者在直立试验过程中CI显著下降( F =6.936, P =0.001),心率明显增快( F = 113.926 , P <0.001),收缩压明显降低( F =6.049, P <0.001),而TPVRI ( F =2.031, P =0.138)和舒张压( F =2.018, P =0.113)无明显变化。健康对照组CI在直立后显著升高( F =3.646, P =0.016),同时心率明显增快( F = 43.970, P <0.001),收缩压( F =4.043, P =0.020)和舒张压( F =8.627, P <0.001)均明显升高,TPVRI ( F = 1.688, P =0.190)无明显变化。POTS患者与健康对照组比较,CI ( F =6.221, P= 0.001)、心率( F =6.203, P < 0.001)和收缩压( F =7.946, P <0.001)随时间变化趋势显著不同,而TPVRI和舒张压在两组间的变化趋势差异无统计学意义( P >0.05)。CI降低组与CI未降低组POTS患者在直立试验中CI变化趋势差异有统计学意义( F = 14.723, P <0.001),前者直立后收缩压明显降低( F =8.010, P <0.001),而后者却无明显变化( F =0.612, P = 0.639 ), TPVRI、心率和舒张压在CI降低组与CI未降低组间随时间变化趋势差异无统计学意义( P >0.05)。年龄是POTS患者直立后CI呈下降趋势的独立影响因素( P =0.013, OR =2.233;95% CI :1.183~4.216)。结论: POTS患者在直立试验过程中存在明显的血流动力学变化,不同患者心输出量变化可能不同,年龄是心输出量下降的独立影响因素。
