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[Efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope].

AbstractOBJECTIVE:
To explore the efficacy of midodrine hydrochloride in the treatment of vasovagal syncope (VVS) in children.
METHODS:
Forty-eight children with unexplained syncope and prodromata (21 males, 27 females, aged 6 -17 years, mean 11 years +/- 3 years) were randomly assigned into 3 groups. They were health education group, cresol group and midodrine hydrochloride group respectively. Cresol group was comprised of children given cresol as first-line therapy in addition to health education and midodrine hydrochloride group patients given midodrine hydrochloride on the basis of cresol group. Repeated head-up tilt testing (HUTT) and follow-ups of at least 6 months were conducted to evaluate the therapeutic efficacy, side effects of midodrine hydrochloride and hemodynamic changes in treating pediatric VVS.
RESULTS:
(1) The HUTT-based effective rate of 3 group was 20.0% (2/10), 60.9% (14/23) and 80.0% (12/15) respectively. It was significantly higher in cases of midodrine hydrochloride group and cresol group than that of health education group (P < 0.05). However,there was no significant difference in the HUTT-based effective rate between cresol group and midodrine hydrochloride group (P > 0.05). (2) During the follow-up period, the recurrence rate of syncope was significantly lower in midodrine hydrochloride group than in other two groups (P < 0.05). However, there was no significant difference in the recurrence rate of syncope between health education and cresol groups (P > 0.05). (3) There was no statistic difference in supine hemodynamic indices (HR, SBP, DBP) between before and after treatment in 3 groups. After midodrine therapy, the effects of midodrine upon changes in systolic and diastolic pressures and heart rate, between upright beginning and supine positions, were statistically significant (P <0.05).
CONCLUSION:
Health education and cresol are conventional therapies for pediatric VVS. The efficacy can be enhanced by supplementing midodrine hydrochloride. Such a regimen is effective and safe in treating pediatric VVS.
AuthorsXiao-Yan Liu, Cheng Wang, Li-Jia Wu, Chun-Yan Hu, Ping Lin, Ming-Xiang Li, Xiao-Li Cui, Zhen-Wu Xie
JournalZhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 89 Issue 28 Pg. 1951-4 (Jul 28 2009) ISSN: 0376-2491 [Print] China
PMID19950567 (Publication Type: English Abstract, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Midodrine
Topics
  • Adolescent
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Midodrine (therapeutic use)
  • Syncope, Vasovagal (drug therapy)
  • Tilt-Table Test
  • Treatment Outcome

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