scholarly journals The predictive value of low urine specific gravity in the diagnosis of vasovagal syncope in children and adolescents

2020 ◽  
Author(s):  
Ping Liu ◽  
Xingfang Zeng ◽  
Hong Yang ◽  
Wanzhen Mei ◽  
Yuwen Wang ◽  
...  
Keyword(s):  
Specific Gravity ◽  
Children And Adolescents ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Predictive Value ◽  
Vasovagal Syncope ◽  
Urine Specific Gravity ◽  
Control Group ◽  
Tilt Table ◽  
Head Up Tilt

Abstract Background Vasovagal syncope (VVS) is a kind of common neurogenic syncope in children and adolescents. Decreased blood volume is one of the pathogenesis of VVS. The study will explore the predictive value of low urine specific gravity (USG) in the diagnosis of VVS in children and adolescents. Methods 97 cases, 43 males and 54 females, aged 4 to 16 years old, with an average age of 10.91 ± 2.18 years old, due to unexplained premonitory syncope or syncope were selected. They were diagnosed with VVS through head-up tilt table test. During the same period, 91 cases of children and adolescents, including 45 males and 46 females, aged from 5 to 15 years old, who underwent a healthy examination were matched as a control (control group). USG was measured in both groups. Results The USG of VVS group was significantly lower than that of the control group (P < 0.01). The sensitivity and specificity of USG prediction in the diagnosis of VVS were evaluated by ROC curve. The area under the ROC curve was 0.751, standard error was 0.035, and 95% CI (0.683, 0.819) suggested that USG was of moderate predictive value in the diagnosis of VVS. Setting USG as < 1.0185, the sensitivity and specificity and diagnostic coincidence rate of VVS were 74.39%, 66.04% and 69.68%, respectively. Conclusion Low USG has predictive value in the diagnosis of VVS in children and adolescents.

scholarly journals The predictive value of urine specific gravity in the diagnosis of vasovagal syncope in children and adolescents

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Ping Liu ◽  
Xingfang Zeng ◽  
Wanzhen Mei ◽  
Yuwen Wang ◽  
Runmei Zou ◽  
...  
Keyword(s):  
Specific Gravity ◽  
Children And Adolescents ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Predictive Value ◽  
Vasovagal Syncope ◽  
Urine Specific Gravity ◽  
Tilt Test ◽  
Control Group ◽  
Neurally Mediated Syncope

Abstract Background Vasovagal syncope (VVS) is a kind of common neurally mediated syncope in children and adolescents. Decreased blood volume is one of the pathogenesis of VVS. The diagnosis of VVS is mainly based on head-up tilt test (HUTT), but some complications may easily occur when HUTT induces syncope. To find a simple and safe VVS diagnosis method can improve the VVS diagnosis efficiency. Aims of the study This was a prospective study. The study will explore the predictive value of urine specific gravity (USG) in the diagnosis of VVS in children and adolescents. Patients and methods Ninety-seven cases (43 males and 54 females, aged 4 to 16 years old, with an average age of 10.91 ± 2.18 years old) hospitalized due to unexplained premonitory syncope or syncope and diagnosed with VVS through HUTT from September 2014 to September 2018 were selected as VVS group. During the same period, 91 cases of children and adolescents, including 45 males and 46 females, aged from 5 to 15 years old, who underwent a healthy examination were matched as a control (control group). USG was measured in both groups. Results The USG of VVS group was significantly lower than that of the control group (P < 0.01), and USG of females was lower than that of males in VVS group (P = 0.045). The sensitivity and specificity of USG in predicting VVS were evaluated by ROC curve. The area under the ROC curve was 0.751, standard error was 0.035, and 95% CI (0.683, 0.819) suggested that USG was of moderate predictive value in the diagnosis of VVS. As cut-off value of USG was 1.0185, the sensitivity and specificity and diagnostic coincidence rate of VVS were 74.39, 66.04 and 69.68%, respectively. Conclusion There are less USG in children and adolescents with VVS, especially lower USG in females. Therefore, USG has predictive value in the diagnosis of VVS in children and adolescents.

scholarly journals Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

2020 ◽  
Vol 17 (18) ◽  
pp. 6441
Author(s):  
Grażyna Markiewicz-Łoskot ◽  
Ewelina Kolarczyk ◽  
Bogusław Mazurek ◽  
Marianna Łoskot ◽  
Lesław Szydłowski
Keyword(s):  
Vasovagal Syncope ◽  
The Other ◽  
Control Group ◽  
Tilt Table Test ◽  
Tilt Table ◽  
T Wave ◽  
Good Discriminator ◽  
Wave Morphology ◽  
Head Up Tilt ◽  
T Waves

The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer (p < 0.001) compared to the other test phases and longer (p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter (p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

scholarly journals The Differences in the Diagnostic Profile in Children with Vasovagal Syncope between the Result of Head-Up Tilt Table Test

2020 ◽  
Vol 17 (12) ◽  
pp. 4524
Author(s):  
Ewelina Kolarczyk ◽  
Lesław Szydłowski ◽  
Agnieszka Skierska ◽  
Grażyna Markiewicz-Łoskot
Keyword(s):  
Medical Records ◽  
Vasovagal Syncope ◽  
Speech Disorders ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Prodromal Symptoms ◽  
Close Relationship ◽  
Head Up Tilt ◽  
Diagnostic Profile ◽  
Positive Results

(1) Background: The features characterizing vasovagal syncope (VVS) are an important factor in the correct evaluation of diagnostic risk stratification in children and adolescents. The aim of the study was to determine the value of identifying the clinical characteristics in children with VVS. (2) Methods: We made a retrospective analysis of the medical records of 109 children with diagnosed VVS. We investigated the specific characteristics of syncope in children with VVS including the positive VVS (+) and negative VVS (−) result of the Head-Up Tilt Table Test (HUTT). (3) Results: We did not observe significant differences in the prodromal symptoms of VVS with HUTT response. In addition to typical prodromal symptoms, no difference in statistically reported palpitations (35/109 or 32.1%) and chest discomfort (27/109 or 27.7%) were recorded. Fear–pain–stress emotions as circumstances of syncope were more often reported by children with a negative HUTT (p = 0.02). Cramps–contractures (p = 0.016) and speech disorders (p = 0.038) were significantly higher in the group with negative HUTT. (4) Conclusions: There is a close relationship in the diagnostic profile between the negative and positive results of head-up tilt table test in children with vasovagal syncope.

scholarly journals The Diagnostic Value of Cardiac Deceleration Capacity in Vasovagal Syncope

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Lihui Zheng ◽  
Wei Sun ◽  
Shangyu Liu ◽  
Erpeng Liang ◽  
Zhongpeng Du ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vasovagal Syncope ◽  
Diagnostic Value ◽  
Control Group ◽  
Vagal Activity ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Good Tool ◽  
Deceleration Capacity ◽  
Vagal Control

Background: Increased parasympathetic activity is thought to play important roles in syncope events of patients with vasovagal syncope (VVS). However, direct measurements of the vagal control are difficult. The novel deceleration capacity (DC) of heart rate measure has been used to characterize the vagal modulation. This study aimed to assess vagal control in patients with VVS and evaluate the diagnostic value of the DC in VVS. Methods: Altogether, 161 consecutive patients with VVS (43±15 years; 62 males) were enrolled. Tilt table test was positive in 101 and negative in 60 patients. Sixty-five healthy subjects were enrolled as controls. DC and heart rate variability in 24-hour ECG, echocardiogram, and biochemical examinations were compared between the syncope and control groups. Results: DC was significantly higher in the syncope group than in the control group (9.6±3.3 versus 6.5±2.0 ms, P <0.001). DC was similarly increased in patients with VVS with a positive and negative tilt table test (9.7±3.5 and 9.4±2.9 ms, P =0.614). In multivariable logistic regression analyses, DC was independently associated with syncope (odds ratio=1.518 [95% CI, 1.301–1.770]; P =0.0001). For the prediction of syncope, the area under curve analysis showed similar values when comparing single DC and combined DC with other risk factors ( P =0.1147). From the receiver operator characteristic curves for syncope discrimination, the optimal cutoff value for the DC was 7.12 ms. Conclusions: DC>7.5 ms may serve as a good tool to monitor cardiac vagal activity and discriminate VVS, particularly in those with negative tilt table test.

The Newcastle protocols 2008: an update on head-up tilt table testing and the management of vasovagal syncope and related disorders

Heart ◽  
2008 ◽  
Vol 95 (5) ◽  
pp. 416-420 ◽  
Author(s):  
S W Parry ◽  
P Reeve ◽  
J Lawson ◽  
F E Shaw ◽  
J Davison ◽  
...  
Keyword(s):  
Vasovagal Syncope ◽  
Tilt Table ◽  
Tilt Table Testing ◽  
Head Up Tilt

scholarly journals ‘Front-loaded’ head-up tilt table testing: validation of a rapid first line nitrate-provoked tilt protocol for the diagnosis of vasovagal syncope

2008 ◽  
Vol 37 (4) ◽  
pp. 411-415 ◽  
Author(s):  
Steve W. Parry ◽  
Janine C. Gray ◽  
Julia L. Newton ◽  
Pamela Reeve ◽  
Diarmuid O'shea ◽  
...  
Keyword(s):  
Vasovagal Syncope ◽  
First Line ◽  
Tilt Table ◽  
Tilt Table Testing ◽  
Head Up Tilt

How valuable is P-wave dispersion in the determination of carboxyhemoglobin levels?

2013 ◽  
Vol 33 (5) ◽  
pp. 466-472
Author(s):  
MT Sener ◽  
Y Anci ◽  
K Kalkan ◽  
MZ Kir ◽  
M Emet
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Wave Dispersion ◽  
P Wave ◽  
Control Group ◽  
Co Poisoning ◽  
P Wave Dispersion ◽  
Cohb Level ◽  
Positive Correlations

Objective: To determine whether or not wave/interval dispersions in electrocardiography (ECG) are increased, and to define whether wave and interval dispersions are correlated with carboxyhemoglobin (COHb) levels. Methods: ECG, complete blood count, and biochemical parameters were taken from 87 patients with carbon monoxide (CO) poisoning as well as 90 control patients with similar age, gender, and body mass index distribution. COHb levels were recorded in CO-poisoning patients. The COHb levels and the relationships with ECG parameters were studied. Results: Pmax, Pmin, Pd, PRmax, PRmin, PRd, QTmax, QTmin, QTd, cQTmax, cQTmin, cQTd, Tmax, Tmin, and Td in ECG were higher in intoxicated patients than the control group ( p < 0.05 for all). Pearson’s correlation analyses showed moderately significant positive correlations between COHb level and Pmax ( r = 0.224; p = 0.037) and Pd ( r = 0.222; p = 0.039). The receiver–operator characteristic (ROC) curve showed that a Pd value of 38 ms determined by ECG separates patients with a COHb ≥ 20% with area under the ROC curve of 0.78 (95%CI = 0.71–0.83), a sensitivity of 67.9% (95%CI = 59.4–75.6), a specificity of 95% (95%CI = 83.0–99.2], a positive predictive value of 97.9% (95%CI = 92.5–99.7), and a negative predictive value of 46.3% (95%CI = 35.3–57.7.) Conclusion: A significant increase in wave/interval dispersions in the ECG of CO-poisoning patients compared with controls may show that not only a part is affected but both atrium and the ventricles as a whole are affected by hypoxic ischemia. When COHb levels of the patients are unavailable, P dispersion on ECG may show CO poisoning level of the patient.

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