title: Plasma C-type natriuretic peptide as a predictor for therapeutic response to metoprolol in children with postural tachycardia syndrome.
abstract: POTS is a global public-health disease, but predictor for therapeutic response to metoprolol in children with POTS is lacking. This study was designed to investigate predictive value of plasma C-type natriuretic peptide (CNP) in the therapeutic efficacy of metoprolol on postural tachycardia syndrome (POTS) in children. Totally 34 children with POTS and 27 healthy children were included in the study. The head-up test or head-up tilt test was used to check heart rate and blood pressure from supine to upright in subjects. A double antibody (competitive) sandwich immunoluminometric assay was used to detect plasma CNP. Metoprolol was used to treat children with POTS. The difference in plasma concentrations of CNP between responders and non-responders was compared. An ROC curve was used to analyze plasma CNP to predict efficacy of metoprolol on POTS in children. Plasma CNP in children with POTS was significantly higher than that of healthy children [(51.9 ± 31.4) vs. (25.1 ± 19.1) pg/ml, P <0.001]. Plasma CNP in responders to metoprolol was significantly higher than non-responders [(59.1 ± 33.5) vs. (34.8 ± 16.7) pg/ml, P = 0.037] before treatment. The ROC curve showed that area under the curve was 0.821 (95% CI 0.642-0.999). The cut-off value of plasma CNP > 32.55 pg/ml yielded a sensitivity of 95.8% and specificity of 70% in predicting therapeutic efficacy of metoprolol on POTS children. Plasma CNP might serve as a useful predictor for the therapeutic efficacy of metoprolol on POTS in children.
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Jing
authors: J
authors: Lin
authors: Department of Pediatrics, Kaifeng Children's Hospital, Henan, China.
authors: Zhenhui
authors: Z
authors: Han
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Hongxia
authors: H
authors: Li
authors: University of California San Diego, La Jolla, California, United States of America.
authors: Selena Ying
authors: SY
authors: Chen
authors: Department of Medical Statistics, Peking University First Hospital, Beijing, China.
authors: Xueying
authors: X
authors: Li
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Ping
authors: P
authors: Liu
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Yuli
authors: Y
authors: Wang
authors: Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China; Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing, China.
authors: Chaoshu
authors: C
authors: Tang
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Junbao
authors: J
authors: Du
authors: Department of Pediatrics, Peking University First Hospital, Beijing, China.
authors: Hongfang
authors: H
authors: Jin
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D016683:Supine Position; D016896:Treatment Outcome
chemical_list: D020098:Natriuretic Peptide, C-Type; D008790:Metoprolol