Orthostatic plasma norepinephrine level as a predictor for therapeutic response to metoprolol in children with postural tachycardia syndrome

Journal of Translational Medicine

Junbao Du¹  Jiawei Li³  Xia Chen²  Qingyou Zhang³ 

[1] Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing 100019, PR China;Department of Pediatrics, Langfang Municipal People¿s Hospital, Langfang 065000, Hebei, PR China;Department of Pediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing 100034, PR China

关键词: Metoprolol;    Postural tachycardia syndrome;    Norepinephrine;   

Others  :  1148090
DOI  :  10.1186/s12967-014-0249-3

 received in 2014-07-31, accepted in 2014-08-29,  发布年份 2014

【 摘 要 】

Background

Postural tachycardia syndrome (POTS) is a heterogeneous disorder that creates challenges for treatment. Beta-blocker was one of the most commonly used drugs, but it is inconsistently effective. The purpose of this study is to explore whether orthostatic plasma norepinephrine level could be an indicator of therapeutic effectiveness of metoprolol for POTS in children.

Methods

Twenty-seven children with POTS were enrolled in our study. They received metoprolol treatment, and their orthostatic plasma norepinephrine levels were measured by high-performance liquid chromatography method. Three months after rmetoprolol treatment, 25 patients were followed up. A receiver-operating characteristic (ROC) curve was used to explore the predictive value of orthostatic plasma norepinephrine level.

Results

The symptom severity and increment of heat rate from supine position to upright of patients positively correlated with their orthostatic plasma norepinephrine level (r?=?0.599, P?P?<0.001, respectively). Orthostatic plasma norepinephrine level in responders to metoprolol was significantly higher than that of nonresponders (P?=?0.028). A ROC curve on the predictive value of orthostatic plasma norepinephrine level showed that the area under the curve was 0.785. Using a cutoff value for orthostatic plasma norepinephrine level of 3.59 pg/ml yielded both sensitivity (76.9%) and specificity (91.7%) in predicting the efficacy of metoprolol therapy for POTS.

Conclusion

Orthostatic plasma norepinephrine level of?>?3.59 pg/ml was an indicator of the effectiveness of metoprolol therapy for POTS in children and adolescents.

【 授权许可】

   
2014 Zhang et al.; licensee BioMed Central Ltd.

【 图 表 】

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