• WangShuoSDepartment of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Graduate Management, Jishou University School of Medicine, Jishou, Hunan, China; Depar, Runmei Zou, Hong Cai, Yuwen Wang, Yiyi Ding, Chuanmei Tan, Maosheng Yang, Fang Li, and Cheng Wang.
• Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Graduate Management, Jishou University School of Medicine, Jishou, Hunan, China; Department of Pediatrics, The First People's Hospital of Changde City, Changde, Hunan, China.
• J. Pediatr. 2020 Sep 1; 224: 110-114.

ObjectiveTo evaluate the ability of heart rate (HR) and HR difference during head-up tilt test (HUTT) and to predict clinical improvement related to metoprolol treatment in children and adolescents with postural tachycardia syndrome (POTS).Study DesignThis was a retrospective cohort study. A total of 53 subjects (27 male, aged 6-12 years old, mean age 11.79 ± 1.50 years old) with POTS treated with metoprolol were involved from July 2012 to September 2019. In total, 52 subjects who underwent health examination during the same period were matched as the control group. Subjects in both groups underwent HUTT. The HR distance between 5 minutes and 0 minutes (HR difference 5) and between 10 minutes and 0 minutes (HR difference 10) during HUTT was calculated.ResultsThe POTS group was significantly greater than the control group in HR 5, HR 10, HR difference 5, and HR difference 10 (P < .01). There was no statistical difference in HR 0 between the 2 groups (P > .05). In total, 53 subjects with POTS were followed up for 96.0 (IQR, 40.5, 134.5) days during treatment with metoprolol. HUTT results demonstrated that 58.49% of subjects with POTS had a response and symptom scores were reduced after intervention. HR and HR difference were useful in predicting the efficacy of metoprolol on POTS. When HR 5, HR 10, HR difference 5, and HR difference 10, respectively, were ≥110, 112, 34, and 37 beats/min, the sensitivity and specificity were 82.50% and 69.23%, 84.62% and 69.70%, 85.29% and 89.47%, and 97.56% and 64.86%, respectively.ConclusionsHR and HR difference are helpful to predict the efficacy of metoprolol on POTS in children and adolescents.Copyright © 2020 Elsevier Inc. All rights reserved.

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