儿童体位性心动过速综合征直立倾斜试验中时间依赖性的心率变化

Time-dependent heart rate variability in the head-up tilt test in children with postural orthostatic tachycardia syndrome

摘要:

目的 分析体位性心动过速综合征(POTS)儿童在直立倾斜试验(HUTT)过程中时间依赖性的心率变化,探讨儿童POTS 的心率诊断标准。方法 回顾性研究2007 年1 月至2014 年12 月的HUTT 10 min内最大心率≥ 120 次/min 诊断为POTS 儿童105 例,分析其在HUTT 10 min 内心率的变化。结果 POTS 儿童由平卧位变为倾斜60° 体位时心率逐渐增加,在HUTT 即刻心率增加24±12 次/min,HUTT 后3 min 心率增加30±14 次/min,5 min 时增加32±13 次/min,10 min 时增加38±12 次/min。10 min 内HUTT 最大心率增加值平均为43±10 次/min。结论 POTS 儿童HUTT 10 min 内心率变化随时间延长而增加,建议儿童POTS 诊断标准中心率增加≥ 40 次/min 较为适合。

Abstract:

Objective To study the time-dependent heart rate (HR) variability in the head-up tilt test (HUTT) in children with postural orthostatic tachycardia syndrome (POTS) and to explore the HR diagnostic criteria for POTS in children. Methods A retrospective analysis was performed on the clinical data of 105 children diagnosed with POTS with HR ≥120 beats per minute (bpm) within the first 10 minutes of HUTT between January 2007 and December 2014. Their HR variability within the first 10 minutes of HUTT was analyzed. Results The HR of children with POTS increased gradually from the supine position to a 60° head-up tilt position, and the increase in HR was 24±12 bpm at the beginning of HUTT, 30±14 bpm at 3 minutes of HUTT, 32±13 bpm at 5 minutes of HUTT, and 38±12 bpm at 10 minutes of HUTT. The average maximal HR increase within the first 10 minutes of HUTT was 43±10 bpm. Conclusions In children with POTS, the HR variability gradually increases with time, and therefore, it is suggested that HR increase ≥40 bpm is more suitable for diagnosis of POTS in children.