A predictive model of response to metoprolol in children and adolescents with postural tachycardia syndrome  

作　　者：Bo-Wen Xu Qing-You Zhang Xue-Ying Li Chao-Shu Tang Jun-Bao Du Xue-Qin Liu Hong-Fang Jin 

机构地区：[1]Department of Pediatrics,Peking University First Hospital,No.1,Xi’an-Men Street,West District,Beijing,100034,China [2]Department of Medical Statistics,Peking University First Hospital,Beijing,China [3]Key Lab of Molecular Cardiovascular Sciences,Ministry of Education,Beijing,China [4]Department of Physiology and Pathophysiology,Peking University Health Science Centre,Beijing,China

出　　处：《World Journal of Pediatrics》2023年第4期390-400,共11页世界儿科杂志（英文版）

基　　金：supported by National High Level Hospital Clinical Research Funding(Multi-center Clinical Research Project of Peking University First Hospital)(2022CR59).

摘　　要：Background The present work was designed to explore whether electrocardiogram(ECG)index-based models could predict the effectiveness of metoprolol therapy in pediatric patients with postural tachycardia syndrome(POTS).Methods This study consisted of a training set and an external validation set.Children and adolescents with POTS who were given metoprolol treatment were enrolled,and after follow-up,they were grouped into non-responders and responders depending on the efficacy of metoprolol.The difference in pre-treatment baseline ECG indicators was analyzed between the two groups in the training set.Binary logistic regression analysis was further conducted on the association between significantly different baseline variables and therapeutic efficacy.Nomogram models were established to predict therapeutic response to metoprolol.The receiver-operating characteristic curve(ROC),calibration,and internal validation were used to evaluate the prediction model.The predictive ability of the model was validated in the external validation set.Results Of the 95 enrolled patients,65 responded to metoprolol treatment,and 30 failed to respond.In the responders,the maximum value of the P wave after correction(Pcmax),P wave dispersion(Pd),Pd after correction(Pcd),QT interval dis-persion(QTd),QTd after correction(QTcd),maximum T-peak-to-T-end interval(Tpemax),and T-peak-to-T-end interval dispersion(Tped)were prolonged(all P<0.01),and the P wave amplitude was increased(P<0.05)compared with those of the non-responders.In contrast,the minimum value of the P wave duration after correction(Pcmin),the minimum value of the QT interval after correction(QTcmin),and the minimum T-peak-to-T-end interval(Tpemin)in the responders were shorter(P<0.01,<0.01 and<0.01,respectively)than those in the non-responders.The above indicators were screened based on the clinical significance and multicollinearity analysis to construct a binary logistic regression.As a result,pre-treatment Pcmax,QTcmin,and Tped were identified as significantly associated fact

关 键 词：CHILDREN ELECTROCARDIOGRAPHY METOPROLOL NOMOGRAM PREDICTOR Postural tachycardia syndrome 

分 类 号：R725.7[医药卫生—儿科]