Physiologic neurocirculatory patterns in the head-up tilt test in children with orthostatic intolerance.
BACKGROUND
Orthostatic intolerance (OI) is a common clinical manifestation in clinical pediatrics. The head-up tilt (HUT) table test is considered the standard of orthostatic assessment, but the physiologic neurocirculatory profile during HUT has not been fully realized in children with OI. The present study, therefore, was designed to investigate the physiologic patterns that occur during HUT in children with OI.


METHODS
Ninety children (56 girls; mean age, 11.6 +/- 2.3 years) with OI underwent HUT under quiet circumstances. Blood pressure and heart rate were monitored simultaneously.


RESULTS
Forty-nine children with OI (54.4%) had vasovagal response with HUT testing; 33 (36.7%), vasodepressor response; six (6.7%), cardioinhibitory response; and 10 (11.1%), mixed response. Twenty-eight children (31.1%) had postural orthostatic tachycardia; one (1.1%), orthostatic hypotension (OH); and 12 (13.3%), normal physiologic response. Patterns of cerebral syncope response and chronotropic incompetence were not observed.


CONCLUSIONS
Classical vasovagal response was the major physiologic pattern seen in children with OI during HUT testing, and postural orthostatic tachycardia response ranked second.
Qingyou
Zhang
Z
Department of Pediatrics, Peking University First Hospital, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China.
Karmane
Sumou I
SI
Junbao
Du
D
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004244:Dizziness / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D019462:Syncope, Vasovagal / Q000209:etiology / Q000503:physiopathology*; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology; D018667:Tilt-Table Test; D014666:Vasomotor System / Q000503:physiopathology*