Different Characteristics Of Vasovagal Syncope And Postural Orthostatic Tachycardia Syndrome In Children With Head-up Tilt Test

Objective: To investigate the different characteristics of VVS and POTS in children with HUTT,in order to identify VVS and POTS accurately in early stage,and to avoid the risk of HUTT examination.Methods: 201 children with VVS or POTS were collected for HUTT in our hospital for of unknown type of syncope.According to the hemodynamic types,201 children were divided into two groups: group VVS(n=103)?group POST(n=98),with regard to sex,age and whether nitroglycerin was taken,the symptoms of syncope,the changes of heart rate,heart rhythm and blood pressure were compared.Results: 201 cases of NMS,103 cases of VVS and 98 cases of POST.1.HUTT hemodynamic types and age: the age of VVS group was 7 years old and 4 month~16 years old and 9 month,average age was(11.99 ±1.99)years old.The age of POST group was 7 years old and 5 month~15 years old and 7 month,average age was(11.67 ±2.0 2)years old,there was no significant difference(P= 0.274 > 0.05).2.HUTT hemodynamic type and sex: the 95 male children with HUTT,the VVS were 46 cases(48.4%),the POST were 49 cases(51.6%);the 106 female children,the VVS were 57 cases(53.8%),the POST were 49 cases(46,2%);there was no significant difference(P = 0.448> 0.05).3.HUTT hemodynamic type and HUTT test method: 30 cases of BHUT were positive:23 cases were VVS(76.7%)and 7 cases were POTS(23.3%).Among the 171 children with positive results of SNHUT,there were 80 cases(46.8%)with VVS and 91 cases(53.2%)with POTS,the difference was statistically significant(P =0.003 < 0.05).4.HUTT hemodynamic types and presyncope : Common in HUTT presyncope manifested as dizziness,palpitations,chest tightness,complexion change,gastrointestinal reaction,blurred vision,cold sweat,and weak.The presyncope of dizziness,blurred vision,Gastrointestinal reaction,change complexion,cold sweat and weak performance in VVS and POTS,the difference was statistically significant(P < 0.05).5.HUTT hemodynamic type with positive reaction time: in BHUT,the median positive reaction time of VVS was 25 min,in POTS was 7 min,the difference was statistically significant(P < 0.05),and in SNHUT,the median positive reaction time of VVS was 5 min,in POST was 4 min,the difference was statistically significant(P < 0.05).6.The positive reaction time and the recovery from positive reaction time in BHUT and SNHUT:The median positive reaction time was 15.5min in BUHT and in SNHUT was 4min.The difference was statistically significant(P < 0.05).And the time recovery from the positive reaction in BHUT and SNHUT was not significant(P < 0.05).7.The results of Logistic regression analysis showed that the presyncope of blurred vision and change complexion was an independent risk factor for the HUTT result of VVS.8.HUTT is a relatively secure test,temporary aphasia,arrhythmia,convulsions,syncope or even cardiac arrest possible occurrence during the course of the trial,be treated with immediate supine,elevation and massage of both lower limbs,and,if necessary,external chest compression,etc.The child can return to normal in a short time.Conclusions: According to the different characteristics of HUTT,VVS and POTS can be accurately identified early,avoid the risk of examination and guide the accurate treatment of VVS and POTS.