Changes of atrial natriuretic peptide and antidiuretic hormone in children with postural tachycardia syndrome and orthostatic hypertension: a case control study.
BACKGROUND
The abnormal blood volume regulation is one of the most important pathogenesis in postural tachycardia syndrome in children. This study was designed to investigate the plasma atrial natriuretic peptide and antidiuretic hormone levels in postural tachycardia syndrome children, and their associations with the changes in heart rate and blood pressure in head-up test.


METHODS
Twenty-one postural tachycardia syndrome patients ((12 ± 2) years) and 26 healthy children ((12 ± 1) years) were included. According to blood pressure changes in head-up test, the postural tachycardia syndrome patients were divided into two subgroups: postural tachycardia syndrome with orthostatic hypertension and postural tachycardia syndrome without orthostatic hypertension. The plasma atrial natriuretic peptide and antidiuretic hormone levels were measured using enzyme-linked immunosorbent assay.


RESULTS
The plasma atrial natriuretic peptide level in postural tachycardia syndrome patients was higher than the control (P = 0.004), whereas the difference in plasma antidiuretic hormone level between postural tachycardia syndrome and controls was not significant (P = 0.222). The plasma antidiuretic hormone level of patients suffering from postural tachycardia syndrome with orthostatic hypertension was much higher than that of children having postural tachycardia syndrome without orthostatic hypertension (P < 0.05). In postural tachycardia syndrome patients, the upright max heart rate was positively correlated with the plasma atrial natriuretic peptide level (r = 0.490, P < 0.05) and the upright systolic blood pressure was positively correlated with the plasma antidiuretic hormone levels (r = 0.472, P < 0.05).


CONCLUSIONS
There was a disturbance of plasma atrial natriuretic peptide and antidiuretic hormone in postural tachycardia syndrome children.
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Juan
J
Zhao
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Jinyan
J
Yang
Department of Pediatrics, Capital Medical University Shijitan Hospital, Beijing 100038, China.
Shuxu
S
Du
Department of Physiology and Pathophysiology, Peking University Health Sciences Centre, Beijing 100191, China; Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing 100191, China.
Chaoshu
C
Tang
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China. Email: junbaodu1@126.com.
Junbao
J
Du
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Hongfang
H
Jin
D000293:Adolescent; D009320:Atrial Natriuretic Factor / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D006801:Humans; D006973:Hypertension / Q000097:blood; D054972:Postural Orthostatic Tachycardia Syndrome / Q000097:blood*; D014667:Vasopressins / Q000097:blood*
D014667:Vasopressins; D009320:Atrial Natriuretic Factor