Baseline left ventricular ejection fraction associated with symptom improvements in both children and adolescents with postural tachycardia syndrome under metoprolol therapy

• Published in: Chinese medical journal 2021-08, Vol.134 (16), p.1977-1982
• Main Authors: Wang, Yuan-Yuan, Han, Zhen-Hui, Wang, Yu-Li, Liao, Ying, Zhang, Chun-Yu, Liu, Ping, Tang, Chao-Shu, Du, Jun-Bao, Jin, Hong-Fang, Huang, Ya-Qian
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Body mass index; Cardiac arrhythmia; Catecholamines; Child; Drug dosages; Ejection fraction; Electrocardiography; Hemodynamics; Hospitals; Humans; Metoprolol - therapeutic use; Original; Patients; Postural Orthostatic Tachycardia Syndrome - drug therapy; Retrospective Studies; Stroke Volume; Teenagers; Values; Ventricular Function, Left
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000001698

Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient's physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS. This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of  0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013). Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.