PMID- 35488638
OWN - NLM
STAT- MEDLINE
DCOM- 20220503
LR  - 20220503
IS  - 0578-1310 (Print)
IS  - 0578-1310 (Linking)
VI  - 60
IP  - 5
DP  - 2022 May 2
TI  - [Risk factors for syncope in children with severe idiopathic pulmonary arterial 
      hypertension].
PG  - 442-446
LID - 10.3760/cma.j.cn112140-20210916-00798 [doi]
AB  - Objective: To explore the risk factors for syncope in children with severe 
      idiopathic pulmonary arterial hypertension (IPAH). Methods: Forty-four patients 
      (age<18 years) with IPAH admitted to the Department of Pediatric Cardiology, 
      Beijing Anzhen Hospital between May 2011 and October 2021 were retrospectively 
      included. Patients were devided into syncope group and non-syncope group. 
      Clinical manifestation and hemodynamic parameters including echocardiography, 
      blood tests, right heart catheterization and acute pulmonary vascular expansion 
      test were compared between two groups. Comparisons between groups were performed 
      with unpaired Student t test, or Mann-Whitney U test or chi-square test. Logistic 
      regression was used to calculate the odds ratio (OR) for parameters with 
      statistically significant differences between groups and analyze the statistical 
      correlation. Results: Among the 44 patients, 16 were males, the onset age was 
      (7.2+/-3.9) years. Twenty-four (55%) children presented with 1 to 11 times of 
      episodes of syncope, and 18 cases of whom induced by physical activity. Syncope 
      group had a larger proportion of New York Heart Association (NYHA) heart function 
      class Ⅲ-Ⅳ (67% (16/24) vs. 25% (5/20), chi(2)=7.59, P=0.006), higher brain 
      natriuretic peptide (BNP) value ((251+/-39) vs. (61+/-40) pg/L, t=-2.18, P=0.035), 
      higher pulmonary-to-aorta diameter ratio (1.6+/-0.4 vs. 1.4+/-0.2, t=-2.25, P=0.030) 
      and larger pulmonary vascular resistance index ((22+/-11) vs. (16+/-7) WU/m(2), 
      t=-2.13, P=0.039) compared with non-syncope group. The proportion of patent 
      foramen ovale (4% (1/24) vs. 45% (9/20), chi(2)=10.36, P=0.001), left ventricular 
      ejection fraction (LVEF) ((68+/-5)% vs. (72+/-8)%, t=2.23, P=0.031) and the positive 
      rate of acute pulmonary vascular expansion test (8% (2/24) vs. 35% (7/20), 
      chi(2)=4.77, P=0.029) of syncope group were significantly lower than those of 
      non-syncope group. Multiple Logistic regression analysis showed that NYHA heart 
      function Ⅲ-Ⅳ (OR=6.787, 95%CI 1.445-31.880), pulmonary vascular resistance index 
      (OR=1.247, 95%CI 1.020-1.525) and BNP (OR=1.036, 95%CI 1.007-1.066) were 
      independent risk factors for syncope. The patent foramen ovale (OR=0.010, 95%CI 
      0.000-0.586) was a protective factor for syncope. Conclusions: NYHA cardiac 
      function grade, pulmonary vascular resistance index and BNP are independent risk 
      factors for syncope. Patent foramen ovale is a protective factor for syncope. 
      Exercise is the main inducement of syncope in children with IPAH.
FAU - Jiang, X K
AU  - Jiang XK
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Xiao, Y Y
AU  - Xiao YY
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Ye, Q
AU  - Ye Q
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Meng, X F
AU  - Meng XF
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Wang, M
AU  - Wang M
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Jin, Y W
AU  - Jin YW
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical 
      University, Beijing 100029, China.
FAU - Qin, Q W
AU  - Qin QW
AD  - Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
FAU - Lyu, Qianwen
AU  - Lyu Q
AD  - Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Er Ke Za Zhi
JT  - Zhonghua er ke za zhi = Chinese journal of pediatrics
JID - 0417427
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - *Foramen Ovale, Patent
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume
MH  - Syncope/etiology
MH  - Ventricular Function, Left
EDAT- 2022/05/01 06:00
MHDA- 2022/05/04 06:00
CRDT- 2022/04/30 04:08
PHST- 2022/04/30 04:08 [entrez]
PHST- 2022/05/01 06:00 [pubmed]
PHST- 2022/05/04 06:00 [medline]
AID - 10.3760/cma.j.cn112140-20210916-00798 [doi]
PST - ppublish
SO  - Zhonghua Er Ke Za Zhi. 2022 May 2;60(5):442-446. doi: 
      10.3760/cma.j.cn112140-20210916-00798.