title: Total peripheral vascular resistance, cardiac output, and plasma C-type natriuretic Peptide level in children with postural tachycardia syndrome.
abstract: OBJECTIVE
  To investigate the total peripheral vascular resistance (TPVR), cardiac output (CO), and plasma C-type natriuretic peptide (CNP) levels in children with postural tachycardia syndrome (POTS) during supine, upright, and return to supine.
  
  
  METHODS
  Twenty-nine children with POTS, aged 12 ± 3 years, were recruited, and 32 healthy children, aged 11 ± 2 years, served as controls. Heart rate (HR), blood pressure, TPVR, and CO were continuously monitored with Finapres Medical System, and plasma CNP levels were detected with Sandwich immunoluminescence assay.
  
  
  RESULTS
  In children with POTS, upright TPVR and CO were significantly lower than those in supine position, and they rose again when they returned to supine position. However, in healthy control patients, both TPVR and CO did not change during supine, upright, and supine again positions. Also, in the supine position, there was no significant difference in TPVR and CO between POTS children and control subjects (P > .05). When upright, however, TPVR and CO in children with POTS were significantly lower than those of controls. Plasma CNP levels were significantly greater in children with POTS than that of controls (32.8 ± 9.7 vs 24.2 ± 8.4 [pg/mL], P < .01), and symptom scores and ΔHR positively correlated with plasma CNP levels in children with POTS (symptom scores: r = 0.490, P < .01; ΔHR: r = 0.508, P < .001), but CO negatively correlated with plasma CNP levels (r = -0.446, P < .01).
  
  
  CONCLUSIONS
  Reduced TPVR and CO associated with the elevated plasma CNP might be involved in the pathogenesis of POTS.
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Li
authors.affiliation: Kaifeng Children's Hospital, Henan, China.
authors.forename: Zhenhui
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Siyao
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liao
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Kaifeng Children's Hospital, Henan, China; Department of Physiology and Pathophysiology, Peking University Health Sciences Centre, Beijing, P. R. China.
authors.forename: Chaoshu
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China; Key Laboratory of Cardiovascular Sciences, Ministry of Education, Beijing, P. R. China.
authors.forename: Junbao
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, P. R. China. Electronic address: jinhongfang51@126.com.
authors.forename: Hongfang
authors.initials: H
authors.lastname: Jin
mesh_terms: D002302:Cardiac Output; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000097:blood* / Q000503:physiopathology*; D011187:Posture; D014655:Vascular Resistance
chemical_list: D020098:Natriuretic Peptide, C-Type