Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome
PurposeTo study whether a Poincaré plot can help predict the curative effect of metoprolol for postural orthostatic tachycardia syndrome (POTS) in children.MethodsPediatric patients with POTS who were administered metoprolol were retrospectively included. The collected data included general data (se...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1280172/full |
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| author | Piaoliu Yuan Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Chunyu Zhang Hongfang Jin Junbao Du Junbao Du Yaqian Huang Ying Liao |
| author_facet | Piaoliu Yuan Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Chunyu Zhang Hongfang Jin Junbao Du Junbao Du Yaqian Huang Ying Liao |
| author_sort | Piaoliu Yuan |
| collection | DOAJ |
| description | PurposeTo study whether a Poincaré plot can help predict the curative effect of metoprolol for postural orthostatic tachycardia syndrome (POTS) in children.MethodsPediatric patients with POTS who were administered metoprolol were retrospectively included. The collected data included general data (sex, age, height, weight, and body mass index), the manifestations and treatment (baseline orthostatic intolerance symptom score and course of metoprolol treatment), vital signs (supine heart rate [HR], supine blood pressure, and increased HR during the standing test), HR variability indexes (standard deviation of normal-to-normal intervals [SDNN]; standard deviation of the averages of normal-to-normal intervals [SDANN]; mean standard deviation of the NN intervals for each 5-min segment [SDNNI]; root mean square of the successive differences [rMSSD]; percentage of adjacent NN intervals that differ by >50 ms [pNN50]; triangular index; ultra-low [ULF], very low [VLF], low [LF], and high frequency [HF]; total power [TP]; and LF/HF ratio), and graphical parameters of the Poincaré plot (longitudinal axis [L], transverse axis [T], and L/T). Receiver operator characteristic curves were used to calculate the predictive function of the indexes with significant differences between patients who responded and those who did not. The index combination with the highest predictive value was obtained through series–parallel analysis.ResultsOverall, 40 responders and 23 non-responders were included. The L and T in the Poincaré plots and rMSSD, pNN50, HF, and TP of the HR variability data were significantly lower in participants who responded to metoprolol than in participants who did not (p < 0.001). The L/T of participants who responded to metoprolol was greater than that of non-responders (p < 0.001). Moreover, we noted a strong correlation between every two indexes among L, T, rMSSD, pNN50, HF, TP, and L/T (p < 0.05). T < 573.9 ms combined with L/T > 2.9 had the best performance for predicting the effectiveness of metoprolol, with a sensitivity of 85.0%, specificity of 82.6%, and accuracy of 84.1%.ConclusionIn the Poincaré plot, a T < 573.9 ms combined with an L/T > 2.9 helps predict good outcomes of using metoprolol to treat pediatric POTS. |
| first_indexed | 2024-03-11T10:33:52Z |
| format | Article |
| id | doaj.art-ba15d72b85a645aa8e01d1cc90e29eb2 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-11T10:33:52Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-ba15d72b85a645aa8e01d1cc90e29eb22023-11-14T11:49:27ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-11-011710.3389/fnins.2023.12801721280172Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndromePiaoliu Yuan0Piaoliu Yuan1Zhouhui Lian2Yuanyuan Wang3Chunyu Zhang4Hongfang Jin5Junbao Du6Junbao Du7Yaqian Huang8Ying Liao9Department of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 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, ChinaState Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing, ChinaPurposeTo study whether a Poincaré plot can help predict the curative effect of metoprolol for postural orthostatic tachycardia syndrome (POTS) in children.MethodsPediatric patients with POTS who were administered metoprolol were retrospectively included. The collected data included general data (sex, age, height, weight, and body mass index), the manifestations and treatment (baseline orthostatic intolerance symptom score and course of metoprolol treatment), vital signs (supine heart rate [HR], supine blood pressure, and increased HR during the standing test), HR variability indexes (standard deviation of normal-to-normal intervals [SDNN]; standard deviation of the averages of normal-to-normal intervals [SDANN]; mean standard deviation of the NN intervals for each 5-min segment [SDNNI]; root mean square of the successive differences [rMSSD]; percentage of adjacent NN intervals that differ by >50 ms [pNN50]; triangular index; ultra-low [ULF], very low [VLF], low [LF], and high frequency [HF]; total power [TP]; and LF/HF ratio), and graphical parameters of the Poincaré plot (longitudinal axis [L], transverse axis [T], and L/T). Receiver operator characteristic curves were used to calculate the predictive function of the indexes with significant differences between patients who responded and those who did not. The index combination with the highest predictive value was obtained through series–parallel analysis.ResultsOverall, 40 responders and 23 non-responders were included. The L and T in the Poincaré plots and rMSSD, pNN50, HF, and TP of the HR variability data were significantly lower in participants who responded to metoprolol than in participants who did not (p < 0.001). The L/T of participants who responded to metoprolol was greater than that of non-responders (p < 0.001). Moreover, we noted a strong correlation between every two indexes among L, T, rMSSD, pNN50, HF, TP, and L/T (p < 0.05). T < 573.9 ms combined with L/T > 2.9 had the best performance for predicting the effectiveness of metoprolol, with a sensitivity of 85.0%, specificity of 82.6%, and accuracy of 84.1%.ConclusionIn the Poincaré plot, a T < 573.9 ms combined with an L/T > 2.9 helps predict good outcomes of using metoprolol to treat pediatric POTS.https://www.frontiersin.org/articles/10.3389/fnins.2023.1280172/fullPoincaré plotmetoprololtherapeutic outcomechildrenpostural orthostatic tachycardia syndrome |
| spellingShingle | Piaoliu Yuan Piaoliu Yuan Zhouhui Lian Yuanyuan Wang Chunyu Zhang Hongfang Jin Junbao Du Junbao Du Yaqian Huang Ying Liao Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome Frontiers in Neuroscience Poincaré plot metoprolol therapeutic outcome children postural orthostatic tachycardia syndrome |
| title | Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| title_full | Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| title_fullStr | Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| title_full_unstemmed | Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| title_short | Poincaré plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| title_sort | poincare plot can help predict the curative effect of metoprolol for pediatric postural orthostatic tachycardia syndrome |
| topic | Poincaré plot metoprolol therapeutic outcome children postural orthostatic tachycardia syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1280172/full |
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