Reduced quality of life and greater psychological distress in vasovagal syncope patients compared to healthy individuals

Ng, Jessica M.Y.; Sheldon, Robert S.; Ritchie, Debbie; Raj, Vidya; Raj, Satish R.

doi:10.1111/pace.13559

Cited by 71 publications

(73 citation statements)

References 27 publications

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“…Children with VVS are highly symptomatic and have a reduced HRQOL. There are limited data comparing HRQOL between VVS patients and healthy individuals [4][5][6][7]10]. Children with VVS were reported to experience lower total score, psychosocial health, emotional functioning, and social functioning in comparison to healthy children.…”

Section: Discussionmentioning

confidence: 99%

“…This impact ranges from effects on education in the young, through impaired social life and ability to drive in adolescence, curtailed career opportunities in adult life, and risk of fractures and other injuries in later years [3]. VVS patients have a reduced HRQOL and poorer psychological profile compared to healthy subjects [4,5]. They also have lower HRQOL scores than patients with diabetes mellitus and similar scores to patients with asthma, end-stage renal disease, obesity, and structural heart disease [6].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Ukrainian version of the PedsQLTM 4.0 Generic Core Scales in children and adolescents with vasovagal syncope

Kovalchuk¹

2020

polp

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Introduction: The aim of the study was to assess the psychometric properties of the Ukrainian translation of the PedsQL™ 4.0 Generic Core Scales for Ukrainian children and adolescents with vasovagal syncope, as well as to study health-related quality of life in this group of paediatric patients. Materials and methods: We studied 56 children, aged eight to 17 years, with a history of vasovagal syncope, and 41 healthy volunteers. Health-related quality of life assessment was performed using the Ukrainian version of the PedsQL™ 4.0 Generic Core Scales for child self-reporting and parent proxy-reporting. Results: There were no significant floor or ceiling effects for any of the summary or scale scores for patient self-reporting and parent proxy-reporting. Cronbach's α coefficient for PedsQL total score for patient self-reporting was 0.90, and for parent proxy-reporting it was 0.88. Paediatric patients with vasovagal syncope (67.92 ±14.52; 77.36 ±21.73; p = 0.01) and their parents (65.13 ±13.94; 71.77 ±13.76; p = 0.02) reported worse PedsQL total scores than healthy children. According to the results of exploratory factor analysis, almost all items of child self-reporting and parent proxy-reporting had a clear factor loading. Regarding construct validity, the results revealed a positive linear relationship between the PedsQL™ 4.0 Generic Core Scales and Modified Calgary Syncope Seizure Score, PedsQL™ General Well-Being Scale, and PedsQL™ Multidimensional Fatigue Scale. Calculation of Pearson's correlation index revealed moderate (0.41-0.60) to good (0.61-0.80) child-parent agreement. Conclusions: The results demonstrate the feasibility, reliability, validity, and agreement between child selfreporting and parent proxy-reporting of the Ukrainian version of the PedsQL™ 4.0 Generic Core Scales for health-related quality of life assessment in children and adolescents with vasovagal syncope. These patients have lower psychosocial health, emotional functioning, and social functioning in comparison to healthy children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of the Ukrainian version of the PedsQLTM 4.0 Generic Core Scales in children and adolescents with vasovagal syncope

Kovalchuk¹

2020

polp

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“…It has been reported that VVS accounts for more than 60% of all pediatric syncopal cases (1,2). Approximately 30% of affected individuals suffer from recurrent syncopal episodes, which significantly impair their quality of life (3,4). Under such circumstances, efficient interventions are required.…”

Section: Introductionmentioning

confidence: 99%

Reduced 24-h Sodium Excretion Is Associated With a Disturbed Plasma Acylcarnitine Profile in Vasovagal Syncope Children: A Pilot Study

et al. 2020

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Objective: To investigate if the low sodium intake is associated with the plasma carnitine and acylcarnitine profile in children with vasovagal syncope (VVS).Materials and Methods: Twenty-six children suffering from VVS were recruited in the present study and divided into a group of low urinary sodium excretion or a group of normal urinary sodium excretion according to the excretion of 24-h urinary sodium <3 or 3-6 g, respectively. The excretion of 24-h urinary sodium was detected with ion-selective electrode approach. Plasma carnitine and acylcarnitine concentrations were measured with tandem mass spectrometry. Each participant completed the head-up tilt test. The demographics, clinical characteristics, hemodynamic parameters and plasma carnitine and acylcarnitine concentrations were compared between the two groups. A bivariate correlation between plasma acylcarnitine profiles and the excretion of 24-h urinary sodium was conducted with Spearman's correlation coefficients.Results: Of the enrolled VVS patients, 14 patients were assigned to the group of low urinary sodium excretion and the remaining 12 patients were assigned to the group of normal urinary sodium excretion. Symptoms of fatigue were more prevalent in the group of low urinary sodium excretion than in the group of normal urinary sodium excretion (p = 0.009). Aside from fatigue, no other differences in the demographics, clinical characteristics or hemodynamic parameters during the head-up tilt test were found between the two groups (p > 0.05). Concentrations of plasma tiglylcarnitine (C5:1), hydroxyhexadecanoylcarnitine (C16OH), hydroxyoctadecanoylcarnitine (C18OH), and carnitine C22 were significantly higher in the group of low urinary sodium excretion than in the group of normal urinary sodium excretion (all p-values = 0.048); moreover, they were all negatively correlated with 24-h urinary sodium levels (all p-values = 0.016). There were no differences between the two groups in other acylcarnitines or free carnitine. Conclusions:Reduced excretion of 24-h urinary sodium is associated with a disturbed plasma acylcarnitine profile in children with VVS. The findings suggest that restricted sodium intake-induced disturbance of plasma acylcarnitines and related cellular energy metabolism might be involved in the pathogenesis of VVS in children.

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“…Vasovagal syncope (VVS) is common in children and significantly affects their quality of life (Ng et al, 2019). Its underlying mechanisms may involve hypovolemia, autonomic dysfunction, vasomotor dysfunction, baroreceptor reflex abnormalities, serotonin surges, etc.…”

Section: Introductionmentioning

confidence: 99%

Baroreflex Sensitivity Predicts Response to Metoprolol in Children With Vasovagal Syncope: A Pilot Study

Tao

Tang

et al. 2019

Front. Neurosci.

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Objective: To explore the role of baroreflex sensitivity (BRS) in the head-up tilt test (HUTT) in predicting the therapeutic response of vasovagal syncope (VVS) patients to metoprolol. Materials and Methods: Vasovagal syncope patients treated with metoprolol were enrolled in this study and were classified as responders or non-responders according to changes in their symptom scores before and after metoprolol treatment. Values of BRS in the supine position and at positive response occurrence in the HUTT were obtained, and BRS changes from supine to positive response occurrence were calculated. Differences between responders and non-responders were analyzed. Receiver operating characteristic curve analysis was performed to assess the value of BRS for predicting the therapeutic efficacy of metoprolol in pediatric patients with VVS. Results: Forty patients (14 boys; 11.8 ± 2.5 years) diagnosed with VVS were recruited in the study, 28 of whom were verified to be responders to metoprolol and 12 of whom were verified as non-responders. They did not show any differences in baseline characteristics and hemodynamics in the HUTT (p > 0.05). However, the responders had an obviously increased supine BRS value compared to the non-responders (16.9 ± 7.7 ms/mmHg vs. 7.6 ± 3.8 ms/mmHg; p < 0.01). No difference in BRS at positive response occurrence was observed between the two groups (8.9 ± 8.5 ms/mmHg vs. 10.6 ± 9.8 ms/mmHg; p > 0.05). Accordingly, the changes in the BRS of responders were more obvious than in non-responders (8.0 ± 7.8 ms/mmHg vs. −3.0 ± 10.4 ms/mmHg; p < 0.01). The area under the receiver operating characteristic curve for the predictive value of supine BRS was 0.887 (95% CI, 0.779-0.995; p < 0.01). A cutoff value of 10 ms/mmHg yielded a sensitivity and specificity of 82 and 83%, respectively, in predicting the therapeutic efficacy of metoprolol in pediatric VVS patients.

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Reduced quality of life and greater psychological distress in vasovagal syncope patients compared to healthy individuals

Cited by 71 publications

References 27 publications

Validation of the Ukrainian version of the PedsQLTM 4.0 Generic Core Scales in children and adolescents with vasovagal syncope

Validation of the Ukrainian version of the PedsQLTM 4.0 Generic Core Scales in children and adolescents with vasovagal syncope

Reduced 24-h Sodium Excretion Is Associated With a Disturbed Plasma Acylcarnitine Profile in Vasovagal Syncope Children: A Pilot Study

Baroreflex Sensitivity Predicts Response to Metoprolol in Children With Vasovagal Syncope: A Pilot Study

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