Plasma Neuropeptide Y Levels in Vasovagal Syncope in Children

Abstract

Background:Vasovagal syncope (VVS) is the most common cause of syncope in children. Neuropeptide Y (NPY) plays an important role in the regulation of blood pressure (BP), as well as myocardial contractility. This study aimed to explore the role of plasma NPY in VVS in children.Methods:Fifty-six children who were diagnosed with VVS (VVS group) using head-up tilt test (HUT) and 31 healthy children who were selected as controls (control group) were enrolled. Plasma NPY concentrations were detected. The independent t-test was used to compare the data of the VVS group with those of the control group. The changes in plasma NPY levels in the VVS group during the HUT, as well as hemodynamic parameters, such as heart rate (HR), BP, total peripheral vascular resistance (TPVR), and cardiac output (CO), were evaluated using the paired t-test. Furthermore, the correlations between plasma NPY levels and hemodynamic parameters were analyzed using bivariate correlation analysis.Results:The BP, HR, and plasma NPY (0.34 ± 0.12 pg/ml vs. 0.46 ± 0.13 pg/ml) levels in the supine position were statistically low in the VVS group compared to levels in the control group (all P < 0.05). Plasma NPY levels were positively correlated with the HR (Pearson, R = 0.395, P < 0.001) and diastolic BP (Pearson, R = 0.311, P = 0.003) when patients were in the supine position. When patients in the VVS group were in the supine position, elevated TPVR (4.6 ± 3.7 mmHg·min−1·L−1 vs. 2.5 ± 1.0 mmHg·min−1·L−1, respectively, P < 0.001; 1 mmHg = 0.133 kPa) and reduced CO (1.0 ± 0.7 L/min vs. 2.4 ± 1.3 L/min, respectively, P < 0.001) were observed in the positive-response period compared with baseline values. The plasma NPY levels were positively correlated with TPVR (Spearman, R = 0.294, P = 0.028) but negatively correlated with CO in the positive-response period during HUT (Spearman, R = −0.318, P = 0.017).Conclusions:Plasma NPY may contribute to the pathogenesis of VVS by increasing the TPVR and decreasing the CO during orthostatic regulation.

Differential Diagnostic Models Between Vasovagal Syncope and Psychogenic Pseudosyncope in Children

“…Baseline SBP, DBP, HR, and QTd were measured in our study. According to previous reports, baseline DBP and HR were significantly lower in the VVS group than in the control group (25), which might be correlated with a deficient circulating volume in VVS patients (26). The relevance between overexcitation of vagal activity and the decreases in baseline HR and BP have also been proposed (27).…”

Serum Neuropeptide Y: A Potential Prognostic Marker of Intracerebral Hemorrhage

“…A recent Chinese study showed that the level of NPY in peripheral blood of epileptic children was significantly increased and was positively correlated with NIHSS score and Hamilton Anxiety (HAMA) scores, suggesting that NPY is involved in the onset of epilepsy [ 23 ]. A study by Peking University showed that plasma NPY is significantly reduced in Vasovagal Syncope, which may participate in the pathogenesis of Vasovagal Syncope by increasing total peripheral vascular resistance and reducing cardiac output [ 24 ]. A study in the United States showed that the increased number of monocytes infiltrated into the brain of NPY-deficient mice can aggravate the process of neurological diseases.…”

Neurohumoral Control of Sinoatrial Node Activity and Heart Rate: Insight From Experimental Models and Findings From Humans

“…A correlation between endogenous NPY and tachycardia was found in adults with heart failure, however, whether this correlation is causative or the change in HR is a confounding variable is unknown (Hulting et al, 1990). Contrarily, in children with vasovagal syncope no correlation was found between NPY levels and HR (Liao et al, 2017). NPY has been investigated broadly for its role in many cardiovascular diseases, but regarding its effect on HR in human, further investigation is needed.…”