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Left Ventricular Ejection Fraction and Fractional Shortening are Useful for the Prediction of the Therapeutic Response to Metoprolol in Children with Vasovagal Syncope

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Abstract

The objective of this manuscript was to explore if left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) could predict the efficacy of metoprolol therapy on vasovagal syncope (VVS) in children. Forty-nine children, including 30 with VVS and 19 gender- and age-matched healthy controls, were included in the study. Metoprolol was prescribed to the VVS subjects. The clinical data were obtained during follow-up at 2 and 6 months. The results showed that LVEF and LVFS of responders were significantly higher than those of non-responders both at the 2-month follow-up (LVEF: 72.5 ± 3.2% vs. 64.6 ± 3.4%; LVFS: 40.9 ± 2.3% vs. 34.9 ± 2.9%), and at the 6-month follow-up (LVEF: 72.8 ± 2.8% vs. 65.5 ± 4.6%; LVFS: 41.1 ± 1.9% vs. 35.8 ± 3.6%). The receiver operating characteristic curve (ROC) analysis demonstrated that 70.5% as a cutoff value of baseline LVEF yielded a sensitivity of 80% and a specificity of 100% in predicting the therapeutic effectiveness of metoprolol at 2 months. For baseline LVFS, 38.5% as a cutoff value yielded a sensitivity of 90% and a specificity of 90%. At the 6-month follow-up, the ROC analysis demonstrated that 70.5% as a cutoff value of baseline LVEF yielded a sensitivity of 81.3% and a specificity of 88.9% in the prediction of metoprolol efficacy. For baseline LVFS, 37.5% as a cutoff value yielded a sensitivity of 93.8% and a specificity of 66.7%. In conclusion, baseline LVEF and LVFS might be useful predictors of the efficacy of β-blocker therapy on VVS in children.

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Funding

This work was supported by Beijing Municipal Science and Technology Major Project (No. Z171100001017253, Beijing, China) and National Youth Top-notch Talent Support Program (China). There has been no other financial support for this work that could have influenced its outcome. The funding agencies had no other involvement, such as study design; the collection, analysis, and interpretation of data; writing the report; and in the decision to submit the article for publication in this work.

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Authors and Affiliations

  1. Department of Pediatrics, Peking University First Hospital, Beijing, 100034, China

    Jingyuan Song, Hongxia Li, Yuli Wang, Ping Liu, Hongfang Jin & Junbao Du

  2. Department of Medical Statistics, Peking University First Hospital, Beijing, 100034, China

    Xueying Li

  3. Department of Physiology and Pathophysiology, Peking University Health Science Centre, Beijing, 100191, China

    Chaoshu Tang

  4. Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing, 100191, China

    Chaoshu Tang & Junbao Du

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  1. Jingyuan Song
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Correspondence to Hongfang Jin or Junbao Du.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Song, J., Li, H., Wang, Y. et al. Left Ventricular Ejection Fraction and Fractional Shortening are Useful for the Prediction of the Therapeutic Response to Metoprolol in Children with Vasovagal Syncope. Pediatr Cardiol 39, 1366–1372 (2018). https://doi.org/10.1007/s00246-018-1904-x

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