Analysis of Factors Relevant to the Severity of Symptoms in Children and Adolescents with Postural Orthostatic Tachycardia Syndrome

TL;DR

This study finds that a heart-related measure called QTcd can predict symptom severity in children with POTS.

Contribution

The study identifies QTcd as a novel and strong indicator of symptom severity in pediatric POTS patients.

Findings

QTcd was independently correlated with symptom severity in pediatric POTS patients.

A QTcd threshold of 45 ms showed high sensitivity and specificity for symptom severity indication.

The area under the ROC curve for QTcd was 0.986, indicating strong predictive power.

Abstract

Objectives: The current study aims to investigate the factors associated with the severity of conditions for pediatric cases with postural orthostatic tachycardia syndrome (POTS). Methods: Patients hospitalized and first diagnosed with POTS were retrospectively included and reviewed. The severity of symptoms was evaluated by symptom scores (SSs). Multiple Spearman correlation analyses and multiple linear regression analyses were used to determine factors independently associated with SS. Patients were divided into the mild (SS ≤ P25) and severe (SS ≥ P75) groups to test the distinguishing efficiency of the candidate factors. The efficiency of each independently correlated factor in indicating the condition of children with POTS was assessed by the receiver operating characteristic (ROC) curve. Results: A series of 296 pediatric patients aged 5–17 years suffering from POTS were included. Multiple Spearman correlation analyses and multiple linear regression analyses showed that corrected QT interval dispersion (QTcd) was independently correlated with SS (p < 0.05). QTcd can be used to suggest the severity of POTS symptoms, and the area under the curve (AUC) was 0.986 (95% CI 0.976–0.997). At a threshold of QTcd = 45 ms, the sensitivity and specificity were, respectively, 94.0% and 91.8% for symptom severity indication. Conclusions: In pediatric cases with POTS, QTcd was positively correlated with their symptom severity and exhibited a strong indicative value. A QTcd of 45 ms was a valid cut-off value for indicating symptom severity.

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