Investigation of 24-hour blood pressure monitoring for evaluating treatment outcome of nerve-mediated syncope in children

XU Yi; LIN Ping; WANG Cheng; WU Li-Jia; KANG Mei-Hua; ZHU Li-Ping; LI Fang; LI Yun-Li; CHU Wei-Hong; RAN Jing

doi:10.7499/j.issn.1008-8830.2013.06.015

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Chinese Journal of Contemporary Pediatrics ›› 2013, Vol. 15 ›› Issue (6) : 458-461. DOI: 10.7499/j.issn.1008-8830.2013.06.015

CLINICAL RESEARCH

Investigation of 24-hour blood pressure monitoring for evaluating treatment outcome of nerve-mediated syncope in children

XU Yi, LIN Ping, WANG Cheng, WU Li-Jia, KANG Mei-Hua, ZHU Li-Ping, LI Fang, LI Yun-Li, CHU Wei-Hong, RAN Jing

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Abstract

OBJECTIVE: To investigate the clinical significance of 24-hour blood pressure monitoring (ABPM) for evaluating the treatment outcome of nerve-mediated syncope (NMS) in children. METHODS: Twenty-eight children with NMS confirmed by a head-up tilt table test (HUTT) (12 males and 16 females, aged 6-13 years) and with a chief complaint of unexplained syncope or pre-syncope between February 2010 and August 2012, were included in the study. These children received health education combined with therapy using oral rehydration salts solution and were then reexamined for clinical symptoms as well as HUTT and ABPM results. RESULTS: Of 28 NMS cases, 22 were vasodepressive type, 5 were mixed type, and 1 was cardioinhibitory type. The follow-up showed that 27 (96%) of all cases had improved clinical symptoms, and 18 (64%) had improved HUTT results. The ABPM follow-up revealed no significant changes in 24-hour mean systolic pressure, 24-hour mean diastolic pressure, daytime mean systolic pressure, daytime mean diastolic pressure, nighttime mean systolic pressure, nighttime mean diastolic pressure, day-night difference of systolic pressure, and day-night difference of diastolic pressure after treatment (P>0.05). The percentage of children with a dipper blood pressure pattern increased from 29% (8/28) before treatment to 50% (14/28) after treatment; the percentage of children with a non-dipper blood pressure pattern decreased from 71% (20/28) before treatment to 50% (14/28) after treatment. CONCLUSIONS: As an effective, objective and non-invasive monitoring means, ABPM is of some clinical significance for evaluating the treatment outcome of NMS in children.

Key words

Nerve-mediated syncope / 24-hour blood pressure monitoring / Headup tilt test / Follow-up / Child

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XU Yi, LIN Ping, WANG Cheng, WU Li-Jia, KANG Mei-Hua, ZHU Li-Ping, LI Fang, LI Yun-Li, CHU Wei-Hong, RAN Jing. Investigation of 24-hour blood pressure monitoring for evaluating treatment outcome of nerve-mediated syncope in children[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(6): 458-461 https://doi.org/10.7499/j.issn.1008-8830.2013.06.015

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