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Relationship between hemodynamic type and syncopal symptoms in pediatric vasovagal syncope
Shuo Wang1,2, Yali Peng3, Runmei Zou1
1Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
European Journal of Pediatrics
|October 19, 2023
Summary
In pediatric vasovagal syncope (VVS), specific hemodynamic types like VVS-cardioinhibited (VVS-CI) and VVS-mixed (VVS-M) significantly increase the risk of syncopal episodes. Understanding these types is crucial for managing VVS in children.
Area of Science:
- Pediatric Cardiology
- Neuroscience
- Clinical Medicine
Background:
- Vasovagal syncope (VVS) is a common neurally mediated syncope in children.
- Research on the link between VVS hemodynamic types and clinical symptoms is limited.
- The comparative risk of syncope across different pediatric VVS hemodynamic types is not well-established.
Purpose of the Study:
- To investigate the relationship between hemodynamic subtypes of VVS and the occurrence of syncopal symptoms in pediatric patients.
- To identify risk factors associated with syncopal episodes in children diagnosed with VVS.
Main Methods:
- Retrospective analysis of 2,513 pediatric patients (ages 3-18) diagnosed with VVS between 2001 and 2021.
- Patients were categorized into syncope (1262 cases) and pre-syncope (1251 cases) groups.
- Statistical analysis, including univariate and multivariate analyses, was performed to assess risk factors.
Main Results:
- The syncope group showed higher age, weight, blood pressure, and a greater proportion of females compared to the pre-syncope group.
- VVS-cardioinhibited (VVS-CI) and VVS-mixed (VVS-M) were identified as independent risk factors for syncopal symptoms.
- VVS-CI and VVS-M presented a 203% and 175% increased probability of syncope, respectively, compared to VVS-vasoinhibited (VVS-VI).
Conclusions:
- Hemodynamic type is a significant factor influencing syncopal symptoms in pediatric VVS.
- VVS-CI and VVS-M are associated with a substantially higher risk of experiencing syncope in children.
- These findings highlight the importance of classifying VVS subtypes for better clinical management.
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