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Published on: March 21, 2013
[Clinical analysis of vasovagal syncope in children]
Chuan Wen1, Cheng Wang, Wen Li
1Department of Cardiovascular Pediatrics, Central South University, Changsha 410011, China.
Insights
Vasovagal syncope (VVS) in children showed increased prevalence and shifts in response types over a decade. These changes suggest that environmental and lifestyle factors significantly influence the development of VVS in pediatric populations.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Disorders
- Clinical Medicine
Context:
- Vasovagal syncope (VVS) is a common cause of syncope in children.
- Understanding changes in VVS clinical features is crucial for diagnosis and management.
- A decade-long study (2000-2009) investigated evolving VVS characteristics in pediatric patients.
Purpose:
- To analyze temporal trends in the clinical presentation of vasovagal syncope (VVS) among children.
- To compare VVS prevalence and response types between two distinct five-year periods.
- To identify age and sex-related differences in VVS presentation.
Summary:
- The study enrolled 841 children with unexplained syncope, divided into two groups based on the study period (2000-2004 vs. 2005-2009).
- A significant increase in the positive head-up tilt table test (HUTT) rate was observed in the later period (47.5% vs. 33.3%).
- Vasodepressor response was most common (70.9%), with a higher proportion in the later study period. HUTT positivity increased with age and was higher in females.
Impact:
- Findings indicate a significant rise in VVS prevalence and a shift towards vasodepressor responses in children over a ten-year span.
- The study highlights the potential influence of evolving social, mental, and lifestyle factors on pediatric VVS.
- Results underscore the need for updated diagnostic and management strategies for VVS in pediatric populations.
Objective:
To study the changes in clinical features of vasovagal syncope (VVS) in children.
Methods:
From January 2000 to September 2009, 841 children with unexplained syncope or prodromata were enrolled. They were assigned to two groups according to the period of visiting hospital: group A (from January 2000 to December 2004, n=129) and group B (from January 2005 to September 2009, n=712). They were assigned to three age groups: 4-6 years old, 7-10 years old and 11-18 years old. A head-up tilt table test (HUTT) was performed on all the subjects.
Results:
The total positive rate of HUTT was 45.3% (381/841). Compared with that in group A, the positive rate of HUTT in group B increased significantly (47.5% vs 33.3%; P<0.05). The positive rate of HUTT in female children was significantly higher than that in male children (49.3% vs 37.9%; P<0.05). The positive rate of HUTT increased with age and it was the highest in children at age of 11-18 years (49.2%), followed by in children at age of 7-10 years (44.1%) and 4-6 years (37.1%) (P<0.05). The children at age of 7-10 years and 11-18 years from group B showed significantly higher positive rate of HUTT than those from group A (46.2% vs 27.8%; 54.0% vs 32.6%, P<0.05). Vasodepressor type was the most common response type (70.9%) shown by HUTT compared with mixed type (25.5%) and cardioinhibitory type (3.6%) (P<0.05). The proportion of children with vasodepressor response type in group B was significantly higher than that in group A (72.5% vs 58.1%; P<0.05).
Conclusions:
There were obvious changes in the prevalence of VVS and response types before and after five years, suggesting that the development of VVS may be attributed to many factors, such as social factors, mental factor and life style.
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