Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children
ObjectivesTo explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients.Materials and MethodsPediatric patients with VVS or POTS, hospitalized in Peking University First Hospi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.758100/full |
| _version_ | 1830511442549276672 |
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| author | Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Yaru Wang Chunyu Zhang Junbao Du Junbao Du Yaqian Huang Ying Liao |
| author_facet | Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Yaru Wang Chunyu Zhang Junbao Du Junbao Du Yaqian Huang Ying Liao |
| author_sort | Piaoliu Yuan |
| collection | DOAJ |
| description | ObjectivesTo explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients.Materials and MethodsPediatric patients with VVS or POTS, hospitalized in Peking University First Hospital between January 2012 and December 2018, were included in a derivation study. The transverse axis (T), longitudinal axis (L), T/L ratio, product T × L, distance between the origin and the proximal end of the longitudinal axis (pro-D), and distance between the origin and distal end of the longitudinal axis (dis-D) of the Poincaré plot were compared between the VVS and POTS groups, and the differential diagnostic performance of the above-mentioned graphic parameters was evaluated using receiver operating characteristic curve analysis. A validation study was conducted in pediatric patients hospitalized between January 2019 and December 2020.ResultsIn school-aged children, the T, L, T/L, T × L, and dis-D values of patients with VVS were greater than those of patients with POTS; in adolescents, the T, T/L, T × L, and pro-D values of patients with VVS were greater than those of patients with POTS. Using a T/L cut-off value of 0.3 to distinguish between the two diseases, the sensitivity and specificity were 91.0 and 90.5%, respectively, for the total participants; 91.6 and 88.9%, respectively, for the school-aged children; and 82.1 and 95.7%, respectively, for the adolescents. In the validation study, a T/L cut-off value of 0.3 yielded an accuracy, sensitivity, and specificity of 81.8, 87.2, and 77.6%, respectively, in the total participants; 76.5, 82.6, and 71.4%, respectively, in the school-aged children; and 89.2, 93.8, and 85.7%, respectively, in the adolescents, in distinguishing VVS from POTS validated by clinical diagnosis.ConclusionsThe graphic parameters of the Poincaré plot are significantly different between VVS and POTS in pediatric patients, and the T/L of the Poincaré plot may be a useful measure to help differentiate VVS from POTS in children and adolescents. |
| first_indexed | 2024-12-22T02:11:22Z |
| format | Article |
| id | doaj.art-956c8db63f364ba8b6e9a5ec80622c3c |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-22T02:11:22Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-956c8db63f364ba8b6e9a5ec80622c3c2022-12-21T18:42:23ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-03-011010.3389/fped.2022.758100758100Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in ChildrenPiaoliu Yuan0Zhouhui Lian1Yuanyuan Wang2Yaru Wang3Chunyu Zhang4Junbao Du5Junbao Du6Yaqian Huang7Ying Liao8Department of Pediatrics, Peking University First Hospital, Beijing, ChinaWang Xuan Institute of Computer Science, Peking University, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaKey Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaObjectivesTo explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients.Materials and MethodsPediatric patients with VVS or POTS, hospitalized in Peking University First Hospital between January 2012 and December 2018, were included in a derivation study. The transverse axis (T), longitudinal axis (L), T/L ratio, product T × L, distance between the origin and the proximal end of the longitudinal axis (pro-D), and distance between the origin and distal end of the longitudinal axis (dis-D) of the Poincaré plot were compared between the VVS and POTS groups, and the differential diagnostic performance of the above-mentioned graphic parameters was evaluated using receiver operating characteristic curve analysis. A validation study was conducted in pediatric patients hospitalized between January 2019 and December 2020.ResultsIn school-aged children, the T, L, T/L, T × L, and dis-D values of patients with VVS were greater than those of patients with POTS; in adolescents, the T, T/L, T × L, and pro-D values of patients with VVS were greater than those of patients with POTS. Using a T/L cut-off value of 0.3 to distinguish between the two diseases, the sensitivity and specificity were 91.0 and 90.5%, respectively, for the total participants; 91.6 and 88.9%, respectively, for the school-aged children; and 82.1 and 95.7%, respectively, for the adolescents. In the validation study, a T/L cut-off value of 0.3 yielded an accuracy, sensitivity, and specificity of 81.8, 87.2, and 77.6%, respectively, in the total participants; 76.5, 82.6, and 71.4%, respectively, in the school-aged children; and 89.2, 93.8, and 85.7%, respectively, in the adolescents, in distinguishing VVS from POTS validated by clinical diagnosis.ConclusionsThe graphic parameters of the Poincaré plot are significantly different between VVS and POTS in pediatric patients, and the T/L of the Poincaré plot may be a useful measure to help differentiate VVS from POTS in children and adolescents.https://www.frontiersin.org/articles/10.3389/fped.2022.758100/fullPoincaré plotvasovagal syncopepostural tachycardia syndromechildrenorthostatic intolerancesyncope |
| spellingShingle | Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Yaru Wang Chunyu Zhang Junbao Du Junbao Du Yaqian Huang Ying Liao Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children Frontiers in Pediatrics Poincaré plot vasovagal syncope postural tachycardia syndrome children orthostatic intolerance syncope |
| title | Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children |
| title_full | Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children |
| title_fullStr | Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children |
| title_full_unstemmed | Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children |
| title_short | Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children |
| title_sort | poincare plot is useful for distinguishing vasovagal syncope from postural tachycardia syndrome in children |
| topic | Poincaré plot vasovagal syncope postural tachycardia syndrome children orthostatic intolerance syncope |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.758100/full |
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