Biomarkers for prognostic assessment of neuromediated syncope in children / 中国小儿急救医学

ABSTRACT

Neuromediated syncope(NMS)is a clinical symptom caused by autonomic reflex mediated changes in vascular tone and heart rate, which can be relieved by supine position.It is a common cause of syncope in children.NMS is divided into vasovagal syncope, postural tachycardia syndrome, orthostatic hypotension and orthostatic hypertension according to hemodynamic types.In recent years, studies on biomarkers for prognostic assessment of children with NMS have continued to deepen.Electrocardiology indicators(QT dispersion, heart rate variability, acceleration index), echocardiography index(flow mediated dilation, ejection fraction, short axial shortening rate), hematology indexes(mean corpuscular hemoglobin concentration, midregional pro-adrenomedullin, erythrocytic hydrogen sulfide, plasma norepinephrine, plasma C-type natriuretic peptide, plasma copeptin), head-up tilt test index(heart rate, heart rate difference, rate pressure product), 24-hour urinary sodium, salivary cortisol, barore reflex sensitivity, body mass index and orthostatic blood pressure changes have good prognostic effects on NMS.With the help of biomarkers, individualized treatment for different populations of NMS can be achieved to improve long-term prognosis.This review summarized the biomarkers used to assess the prognosis of children with NMS.