Postural orthostatic tachycardia syndrome with increased erythrocytic hydrogen sulfide and response to midodrine hydrochloride.

Abstract

OBJECTIVES:

To evaluate the use of erythrocytic hydrogen sulfide (H2S) in predicting the therapeutic efficacy of midodrine hydrochloride for children with postural orthostatic tachycardia syndrome (POTS).

STUDY DESIGN:

Fifty-five children were included in this study, involving 28 children with POTS (POTS group) and 27 healthy children (control group). Children in the POTS group received midodrine hydrochloride treatment. Erythrocytic H2S production was measured; a receiver operating characteristic curve was used to assess if erythrocytic H2S could predict the therapeutic response to midodrine hydrochloride treatment.

RESULTS:

H2S production from erythrocytes was significantly higher in the POTS group than in the control group (P < .01). H2S production was also significantly higher in responders to midodrine hydrochloride than in non-responders (P < .05). The change in symptom score and baseline erythrocytic H2S production had a positive linear relationship (P < .01). There was also a positive correlation with the change in heart rate (P < .05). The receiver operating characteristic curve showed an area under curve value of 0.813. Erythrocytic H2S production yielded a sensitivity of 78.9% and a specificity of 77.8% in predicting the efficacy of midodrine hydrochloride therapy for children with POTS.

CONCLUSION:

Erythrocytic H2S could serve as a useful predictor of therapeutic response to midodrine hydrochloride in children with POTS.

• Authors: Jinyan Yang, Juan Zhao, Shuxu Du, Die Liu, Chunhin Fu, Xueying Li, Stella Chen, Chaoshu Tang, Junbao Du, Hongfang Jin
• Journal: The Journal of pediatrics (J Pediatr) Vol. 163 Issue 4 Pg. 1169-73.e2 (Oct 2013) ISSN: 1097-6833 [Electronic] United States
• PMID: 23726544 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Mosby, Inc. All rights reserved.

Chemical References

• Sympathomimetics
• Midodrine
• Hydrogen Sulfide

Topics

• Area Under Curve
• Case-Control Studies
• Child
• Child, Preschool
• Electrocardiography
• Erythrocytes (cytology, metabolism)
• Female
• Heart Rate
• Humans
• Hydrogen Sulfide (blood)
• Male
• Midodrine (therapeutic use)
• Postural Orthostatic Tachycardia Syndrome (blood, diagnosis)
• ROC Curve
• Sensitivity and Specificity
• Sympathomimetics (therapeutic use)