The Experts below are selected from a list of 501 Experts worldwide ranked by ideXlab platform

Du Junbao - One of the best experts on this subject based on the ideXlab platform.

  • Plasma Copeptin and Therapeutic Effectiveness of Midodrine Hydrochloride on Postural Tachycardia Syndrome in Children
    journal of pediatrics, 2014
    Co-Authors: Zhao Juan, Tang Chaoshu, Jin Hongfang, Du Junbao
    Abstract:

    Objectives Midodrine hydrochloride is used clinically to treat children with postural tachycardia syndrome (POTS), but it is not effective in all patients. This study was designed to explore the changes in plasma copeptin and its predictive value in assessing the therapeutic efficacy of Midodrine hydrochloride in children with POTS. Study design The study included 33 children with POTS and 26 healthy children. The group with POTS received Midodrine hydrochloride treatment for 1.5-3 months. The plasma copeptin was measured using a sandwich immunoluminometric assay. A receiver operating characteristic curve was used to explore the predictive value of plasma copeptin. Results The plasma copeptin in the group with POTS was significantly higher than that of the control group (10.827 +/- 2.459 pmol/L vs 8.845 +/- 1.471 pmol/L, P < .001). The plasma copeptin in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (12.082 +/- 1.998 pmol/L vs 9.646 +/- 2.301 pmol/L, P = .003). Receiver operating characteristic analysis on the predictive value of plasma copeptin showed that the area under the curve was 0.800 with a 95% CI of 0.640-0.959. Using a plasma copeptin level of 10.482 pmol/L as the cutoff point produced both favorite sensitivity (81.3%) and specificity (76.5%) in predicting the efficacy of Midodrine hydrochloride therapy in children with POTS. Conclusions Plasma copeptin may be considered as a predictive biomarker for the likelihood of successful treatment of children with POTS with Midodrine hydrochloride.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000341435800017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701PediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com; junbaodu1@126.com2290-29416

  • Difference between Supine and Upright Blood Pressure Associates to the Efficacy of Midodrine on Postural Orthostatic Tachycardia Syndrome (POTS) in Children
    pediatric cardiology, 2014
    Co-Authors: Deng Wenjun, Yang Jinyan, Li Xueying, Tang Chaoshu, Du Junbao, Ochs Todd, Liu Yanling, Liu, Angie Dong, Holmberg Lukas, Jin Hongfang
    Abstract:

    Postural orthostatic tachycardia syndrome (POTS) is common, and has a serious impact on children's quality of life. Midodrine hydrochloride, an alpha 1-adrenoreceptor agonist, is an effective treatment. The study was designed to examine the therapeutic efficacy of Midodrine hydrochloride by quantifying changes in blood pressure during the head-up test (HUT), in children with POTS. Overall, 104 out of 110 children with POTS were treated with Midodrine hydrochloride and successfully followed-up. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes were analyzed during the HUT. In a retrospective analysis, a receiver operating characteristic (ROC) curve was used to analyze the therapeutic predictive value of pre-treatment changes in SBP, DBP, and a combination of both, from the supine position to standing, in the subjects. The increase of SBP and DBP from the supine position to standing in responders were significantly lower than that of the non-responders. The ROC curve showed that Midodrine hydrochloride for children with POTS would be predicted to be effective when the pre-treatment increase of SBP was a parts per thousand currency sign0 mmHg, or when the pre-treatment increase of DBP was a parts per thousand currency sign6.5 mmHg (from the supine position to standing), yielding a sensitivity of 72 % and specificity of 88 %. The area under the curve was 0.744 and 0.809, respectively. Hence, the results suggested that looking at the changes in blood pressure during the HUT was useful in predicting the response to Midodrine hydrochloride in children with POTS.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000333165400023&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Cardiac & Cardiovascular SystemsPediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com4719-7253

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    journal of pediatrics, 2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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.PediatricsSCI(E)PubMed9ARTICLE41169-+16

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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

  • Midregional Pro-Adrenomedullin as a Predictor for Therapeutic Response to Midodrine Hydrochloride in Children With Postural Orthostatic Tachycardia Syndrome
    'Elsevier BV', 2012
    Co-Authors: Zhang Fengwen, Li Xueying, Tang Chaoshu, Jin Hongfang, Ochs Todd, Li Chen, Liao Ying, Du Junbao
    Abstract:

    ObjectivesThis study was designed to explore the predictive value of the midregional fragment of pro-adrenomedullin (MR-proADM) in assessing the therapeutic efficacy of Midodrine hydrochloride for children with postural orthostatic tachycardia syndrome (POTS).BackgroundMidodrine hydrochloride is an important therapeutic option for children with POTS. However, there has not been any method to predict response to the drug. The MR-proADM is produced in equimolar amounts to adrenomedullin (ADM), and directly reflects levels of the rapidly degraded active peptide, ADM.MethodsFifty-seven children with POTS were designated as the POTS group. Twenty healthy children served as the control group. The children in the POTS group received Midodrine hydrochloride treatment. The plasma concentration of MR-proADM was measured, using a sandwich immunoluminometric assay. A receiver-operating characteristic curve was used to explore the predictive value of MR-proADM.ResultsPlasma levels of MR-proADM were significantly higher in children with POTS (75.0 [62.5 to 96.0] pg/ml) than in the control group (58.5 [50.3 to 69.0] pg/ml). Plasma levels of MR-proADM in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (76.0 [66.0 to 91.0] pg/ml vs. 59.0 [54.0 to 65.5] pg/ml, p < 0.01]. A receiver-operating characteristic curve on the predictive value of MR-proADM showed that the area under the curve was 0.879 with a 95% confidence interval of 0.761 to 0.997. Using a cutoff value for MR-proADM of 61.5 pg/ml produced both high sensitivity (100%) and specificity (71.6%) in predicting the efficacy of Midodrine hydrochloride therapy for treating POTS.ConclusionsMR-proADM can help guide Midodrine hydrochloride therapy in the management of POTS in children

Tang Chaoshu - One of the best experts on this subject based on the ideXlab platform.

  • Plasma Copeptin and Therapeutic Effectiveness of Midodrine Hydrochloride on Postural Tachycardia Syndrome in Children
    journal of pediatrics, 2014
    Co-Authors: Zhao Juan, Tang Chaoshu, Jin Hongfang, Du Junbao
    Abstract:

    Objectives Midodrine hydrochloride is used clinically to treat children with postural tachycardia syndrome (POTS), but it is not effective in all patients. This study was designed to explore the changes in plasma copeptin and its predictive value in assessing the therapeutic efficacy of Midodrine hydrochloride in children with POTS. Study design The study included 33 children with POTS and 26 healthy children. The group with POTS received Midodrine hydrochloride treatment for 1.5-3 months. The plasma copeptin was measured using a sandwich immunoluminometric assay. A receiver operating characteristic curve was used to explore the predictive value of plasma copeptin. Results The plasma copeptin in the group with POTS was significantly higher than that of the control group (10.827 +/- 2.459 pmol/L vs 8.845 +/- 1.471 pmol/L, P < .001). The plasma copeptin in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (12.082 +/- 1.998 pmol/L vs 9.646 +/- 2.301 pmol/L, P = .003). Receiver operating characteristic analysis on the predictive value of plasma copeptin showed that the area under the curve was 0.800 with a 95% CI of 0.640-0.959. Using a plasma copeptin level of 10.482 pmol/L as the cutoff point produced both favorite sensitivity (81.3%) and specificity (76.5%) in predicting the efficacy of Midodrine hydrochloride therapy in children with POTS. Conclusions Plasma copeptin may be considered as a predictive biomarker for the likelihood of successful treatment of children with POTS with Midodrine hydrochloride.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000341435800017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701PediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com; junbaodu1@126.com2290-29416

  • Difference between Supine and Upright Blood Pressure Associates to the Efficacy of Midodrine on Postural Orthostatic Tachycardia Syndrome (POTS) in Children
    pediatric cardiology, 2014
    Co-Authors: Deng Wenjun, Yang Jinyan, Li Xueying, Tang Chaoshu, Du Junbao, Ochs Todd, Liu Yanling, Liu, Angie Dong, Holmberg Lukas, Jin Hongfang
    Abstract:

    Postural orthostatic tachycardia syndrome (POTS) is common, and has a serious impact on children's quality of life. Midodrine hydrochloride, an alpha 1-adrenoreceptor agonist, is an effective treatment. The study was designed to examine the therapeutic efficacy of Midodrine hydrochloride by quantifying changes in blood pressure during the head-up test (HUT), in children with POTS. Overall, 104 out of 110 children with POTS were treated with Midodrine hydrochloride and successfully followed-up. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes were analyzed during the HUT. In a retrospective analysis, a receiver operating characteristic (ROC) curve was used to analyze the therapeutic predictive value of pre-treatment changes in SBP, DBP, and a combination of both, from the supine position to standing, in the subjects. The increase of SBP and DBP from the supine position to standing in responders were significantly lower than that of the non-responders. The ROC curve showed that Midodrine hydrochloride for children with POTS would be predicted to be effective when the pre-treatment increase of SBP was a parts per thousand currency sign0 mmHg, or when the pre-treatment increase of DBP was a parts per thousand currency sign6.5 mmHg (from the supine position to standing), yielding a sensitivity of 72 % and specificity of 88 %. The area under the curve was 0.744 and 0.809, respectively. Hence, the results suggested that looking at the changes in blood pressure during the HUT was useful in predicting the response to Midodrine hydrochloride in children with POTS.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000333165400023&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Cardiac & Cardiovascular SystemsPediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com4719-7253

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    journal of pediatrics, 2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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.PediatricsSCI(E)PubMed9ARTICLE41169-+16

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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

  • Midregional Pro-Adrenomedullin as a Predictor for Therapeutic Response to Midodrine Hydrochloride in Children With Postural Orthostatic Tachycardia Syndrome
    'Elsevier BV', 2012
    Co-Authors: Zhang Fengwen, Li Xueying, Tang Chaoshu, Jin Hongfang, Ochs Todd, Li Chen, Liao Ying, Du Junbao
    Abstract:

    ObjectivesThis study was designed to explore the predictive value of the midregional fragment of pro-adrenomedullin (MR-proADM) in assessing the therapeutic efficacy of Midodrine hydrochloride for children with postural orthostatic tachycardia syndrome (POTS).BackgroundMidodrine hydrochloride is an important therapeutic option for children with POTS. However, there has not been any method to predict response to the drug. The MR-proADM is produced in equimolar amounts to adrenomedullin (ADM), and directly reflects levels of the rapidly degraded active peptide, ADM.MethodsFifty-seven children with POTS were designated as the POTS group. Twenty healthy children served as the control group. The children in the POTS group received Midodrine hydrochloride treatment. The plasma concentration of MR-proADM was measured, using a sandwich immunoluminometric assay. A receiver-operating characteristic curve was used to explore the predictive value of MR-proADM.ResultsPlasma levels of MR-proADM were significantly higher in children with POTS (75.0 [62.5 to 96.0] pg/ml) than in the control group (58.5 [50.3 to 69.0] pg/ml). Plasma levels of MR-proADM in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (76.0 [66.0 to 91.0] pg/ml vs. 59.0 [54.0 to 65.5] pg/ml, p < 0.01]. A receiver-operating characteristic curve on the predictive value of MR-proADM showed that the area under the curve was 0.879 with a 95% confidence interval of 0.761 to 0.997. Using a cutoff value for MR-proADM of 61.5 pg/ml produced both high sensitivity (100%) and specificity (71.6%) in predicting the efficacy of Midodrine hydrochloride therapy for treating POTS.ConclusionsMR-proADM can help guide Midodrine hydrochloride therapy in the management of POTS in children

Jin Hongfang - One of the best experts on this subject based on the ideXlab platform.

  • Plasma Copeptin and Therapeutic Effectiveness of Midodrine Hydrochloride on Postural Tachycardia Syndrome in Children
    journal of pediatrics, 2014
    Co-Authors: Zhao Juan, Tang Chaoshu, Jin Hongfang, Du Junbao
    Abstract:

    Objectives Midodrine hydrochloride is used clinically to treat children with postural tachycardia syndrome (POTS), but it is not effective in all patients. This study was designed to explore the changes in plasma copeptin and its predictive value in assessing the therapeutic efficacy of Midodrine hydrochloride in children with POTS. Study design The study included 33 children with POTS and 26 healthy children. The group with POTS received Midodrine hydrochloride treatment for 1.5-3 months. The plasma copeptin was measured using a sandwich immunoluminometric assay. A receiver operating characteristic curve was used to explore the predictive value of plasma copeptin. Results The plasma copeptin in the group with POTS was significantly higher than that of the control group (10.827 +/- 2.459 pmol/L vs 8.845 +/- 1.471 pmol/L, P < .001). The plasma copeptin in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (12.082 +/- 1.998 pmol/L vs 9.646 +/- 2.301 pmol/L, P = .003). Receiver operating characteristic analysis on the predictive value of plasma copeptin showed that the area under the curve was 0.800 with a 95% CI of 0.640-0.959. Using a plasma copeptin level of 10.482 pmol/L as the cutoff point produced both favorite sensitivity (81.3%) and specificity (76.5%) in predicting the efficacy of Midodrine hydrochloride therapy in children with POTS. Conclusions Plasma copeptin may be considered as a predictive biomarker for the likelihood of successful treatment of children with POTS with Midodrine hydrochloride.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000341435800017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701PediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com; junbaodu1@126.com2290-29416

  • Difference between Supine and Upright Blood Pressure Associates to the Efficacy of Midodrine on Postural Orthostatic Tachycardia Syndrome (POTS) in Children
    pediatric cardiology, 2014
    Co-Authors: Deng Wenjun, Yang Jinyan, Li Xueying, Tang Chaoshu, Du Junbao, Ochs Todd, Liu Yanling, Liu, Angie Dong, Holmberg Lukas, Jin Hongfang
    Abstract:

    Postural orthostatic tachycardia syndrome (POTS) is common, and has a serious impact on children's quality of life. Midodrine hydrochloride, an alpha 1-adrenoreceptor agonist, is an effective treatment. The study was designed to examine the therapeutic efficacy of Midodrine hydrochloride by quantifying changes in blood pressure during the head-up test (HUT), in children with POTS. Overall, 104 out of 110 children with POTS were treated with Midodrine hydrochloride and successfully followed-up. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes were analyzed during the HUT. In a retrospective analysis, a receiver operating characteristic (ROC) curve was used to analyze the therapeutic predictive value of pre-treatment changes in SBP, DBP, and a combination of both, from the supine position to standing, in the subjects. The increase of SBP and DBP from the supine position to standing in responders were significantly lower than that of the non-responders. The ROC curve showed that Midodrine hydrochloride for children with POTS would be predicted to be effective when the pre-treatment increase of SBP was a parts per thousand currency sign0 mmHg, or when the pre-treatment increase of DBP was a parts per thousand currency sign6.5 mmHg (from the supine position to standing), yielding a sensitivity of 72 % and specificity of 88 %. The area under the curve was 0.744 and 0.809, respectively. Hence, the results suggested that looking at the changes in blood pressure during the HUT was useful in predicting the response to Midodrine hydrochloride in children with POTS.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000333165400023&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Cardiac & Cardiovascular SystemsPediatricsSCI(E)PubMed3ARTICLEjinhongfang51@126.com4719-7253

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    journal of pediatrics, 2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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.PediatricsSCI(E)PubMed9ARTICLE41169-+16

  • Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride
    2013
    Co-Authors: Yang Jinyan, Zhao Juan, Du Shuxu, Liu Die, Fu Chunhin, Li Xueying, Chen Stella, Tang Chaoshu, Du Junbao, Jin Hongfang
    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

  • Midregional Pro-Adrenomedullin as a Predictor for Therapeutic Response to Midodrine Hydrochloride in Children With Postural Orthostatic Tachycardia Syndrome
    'Elsevier BV', 2012
    Co-Authors: Zhang Fengwen, Li Xueying, Tang Chaoshu, Jin Hongfang, Ochs Todd, Li Chen, Liao Ying, Du Junbao
    Abstract:

    ObjectivesThis study was designed to explore the predictive value of the midregional fragment of pro-adrenomedullin (MR-proADM) in assessing the therapeutic efficacy of Midodrine hydrochloride for children with postural orthostatic tachycardia syndrome (POTS).BackgroundMidodrine hydrochloride is an important therapeutic option for children with POTS. However, there has not been any method to predict response to the drug. The MR-proADM is produced in equimolar amounts to adrenomedullin (ADM), and directly reflects levels of the rapidly degraded active peptide, ADM.MethodsFifty-seven children with POTS were designated as the POTS group. Twenty healthy children served as the control group. The children in the POTS group received Midodrine hydrochloride treatment. The plasma concentration of MR-proADM was measured, using a sandwich immunoluminometric assay. A receiver-operating characteristic curve was used to explore the predictive value of MR-proADM.ResultsPlasma levels of MR-proADM were significantly higher in children with POTS (75.0 [62.5 to 96.0] pg/ml) than in the control group (58.5 [50.3 to 69.0] pg/ml). Plasma levels of MR-proADM in responders to Midodrine hydrochloride was significantly higher than that of nonresponders (76.0 [66.0 to 91.0] pg/ml vs. 59.0 [54.0 to 65.5] pg/ml, p < 0.01]. A receiver-operating characteristic curve on the predictive value of MR-proADM showed that the area under the curve was 0.879 with a 95% confidence interval of 0.761 to 0.997. Using a cutoff value for MR-proADM of 61.5 pg/ml produced both high sensitivity (100%) and specificity (71.6%) in predicting the efficacy of Midodrine hydrochloride therapy for treating POTS.ConclusionsMR-proADM can help guide Midodrine hydrochloride therapy in the management of POTS in children

Horacio Kaufmann - One of the best experts on this subject based on the ideXlab platform.

  • l dops therapy for refractory orthostatic hypotension in autoimmune autonomic neuropathy
    Neurology, 2005
    Co-Authors: Christopher H Gibbons, Horacio Kaufmann, Steven Vernino, Roy Freeman
    Abstract:

    The authors report a 46-year-old woman with antibodies to the nicotinic acetylcholine receptor (NiAchR) of the autonomic ganglia. She presented with severe orthostatic intolerance refractory to treatment with Midodrine, fludrocortisone, erythropoietin, vasopressin, salt, and fluid loading. Addition of l-threo-3,4-dihidroxyphenylserine (l-DOPS) substantially improved blood pressure and orthostatic tolerance. l-DOPS may benefit patients with severe orthostatic intolerance and be particularly effective in patients with ganglionic NiAchR antibodies.

  • Midodrine in neurally mediated syncope a double blind randomized crossover study
    Annals of Neurology, 2002
    Co-Authors: Horacio Kaufmann, Daniela Saadia, Andrei Voustianiouk
    Abstract:

    Neurally mediated syncope is the most frequent cause of syncope in patients without structural heart disease. Its most common trigger is a reduction in venous return to the heart due to excessive venous pooling in the legs. We conducted a double-blind, randomized, crossover trial to investigate the efficacy of Midodrine, a selective alpha-1 adrenergic agonist that decreases venous capacitance, in preventing neurally mediated syncope triggered by passive head-up tilt. Twelve patients with history of recurrent neurally mediated syncope, which was reproduced during head-up tilt, were randomized to receive a nonpressor dose of Midodrine (5mg) or placebo on day 1 and the opposite on day 3. One hour after drug or placebo administration, patients underwent 60-degree head-up tilt lasting 40 minutes (unless hypotension or bradycardia developed first). In the supine position, Midodrine produced no significant change in blood pressure or heart rate. The responses to head-up tilt were significantly different on the Midodrine and the placebo day: on the placebo day, 67% (8/12) of the subjects suffered neurally mediated syncope, whereas only 17% (2/12) of the subjects developed neurally mediated syncope on the Midodrine day (p < 0.02). These results indicate that Midodrine significantly improves orthostatic tolerance during head-up tilt in patients with recurrent neurally mediated syncope.

  • a double blind dose response study of Midodrine in neurogenic orthostatic hypotension
    Neurology, 1998
    Co-Authors: R A Wright, Tonette L Opfergehrking, Horacio Kaufmann, R Perera, M A Mcelligott, K N Sheng
    Abstract:

    Objective: To determine the best therapeutic strategy for the use of Midodrine in patients with neurogenic orthostatic hypotension (NOH). Background: Midodrine is a peripherally acting α-adrenergic agonist useful in the treatment of NOH. However, neither the most effective dosage of Midodrine nor the required frequency of administration is established. Design/Methods: Midodrine dose-blood pressure response, pharmacokinetics, and duration of action were examined in a double-blind, placebo-controlled, four-way crossover trial. Twenty-five patients with NOH were randomized to receive on successive days placebo or Midodrine 2.5, 10, or 20 mg. Blood pressures of patients in the supine and standing positions were measured sequentially. A global assessment of the patient9s overall symptom improvement after each leg of the study was performed. Blood levels of Midodrine and its active metabolite, desglyMidodrine, were assayed. Results: Midodrine significantly increased standing systolic blood pressure, with the increase peaking at 1 hour. There was a significant linear relation between Midodrine dosage and mean systolic blood pressure. The mean score for global improvement of symptoms was significantly higher for Midodrine (10 and 20 mg) compared with placebo. The half-life of desglyMidodrine was ∼4 hours. Conclusion: A 10-mg dose of Midodrine prescribed two to three times daily is effective in increasing orthostatic blood pressure and ameliorating symptoms in patients with NOH.

  • neurogenic orthostatic hypotension a double blind placebo controlled study with Midodrine
    The American Journal of Medicine, 1993
    Co-Authors: Joseph Jankovic, Janice L Gilden, Bradley C Hiner, Horacio Kaufmann, David C Brown, Cecil Coghlan, Michael Rubin, Fetnat M Fouadtarazi
    Abstract:

    PURPOSE: To investigate the efficacy and safety of Midodrine for treatment of patients with orthostatic hypotension due to autonomic failure. PATIENTS: Ninety-seven patients with orthostatic hypotension were randomized in a 4-week, double-blinded, placebo-controlled study with a 1-week placebo run-in period. Patients ranged in age from 22 to 86 years (mean: 61 years). METHODS: After a 1-week run-in phase, either placebo or Midodrine at a dose of 2.5 mg, 5 mg, or 10 mg was administered three times a day for 4 weeks. Both the placebo group and the 2.5-mg Midodrine group received constant doses throughout the double-blind phase. The patients receiving 5 mg or 10 mg of Midodrine were given doses that were increased at weekly intervals by 2.5-mg increments until the designated dose was reached. Efficacy evaluations were based on an improvement at 1-hour postdose in standing systolic blood pressure and in symptoms of orthostatic hypotension (syncope, dizziness/lightheadedness, weakness/fatigue, and low energy level). RESULTS: Midodrine (10 mg) increased standing systolic blood pressure by 22 mm Hg (28%, p < 0.001 versus placebo). Midodrine improved (p < 0.05) the following symptoms of orthostatic hypotension compared to placebo: dizziness/lightheadedness, weakness/fatigue, syncope, low energy level, impaired ability to stand, and feelings of depression. The overall side effects were mainly mild to moderate. One or more side effects were reported by 22% of the placebo group compared with 27% of the Midodrine-treated group. Scalp pruritus/tingling, which was reported by 10 of 74 (13.5%) of the Midodrine-treated patients, was most frequent. Other reported side effects included supine hypertension (8%) and feelings of urinary urgency (4%). CONCLUSION: We conclude that Midodrine is an effective and well-tolerated treatment for moderate-to-severe orthostatic hypotension associated with autonomic failure.

Fetnat M Fouadtarazi - One of the best experts on this subject based on the ideXlab platform.

  • alpha sympathomimetic treatment of autonomic insufficiency with orthostatic hypotension
    The American Journal of Medicine, 1995
    Co-Authors: Fetnat M Fouadtarazi, Masanori Okabe, Hershel Goren
    Abstract:

    PURPOSE In this double-blind study, the authors compared the safety and efficacy of the investigational oral agent Midodrine, a specific alpha 1-sympathomimetic agent, with ephedrine, a nonspecific alpha- and beta-adrenergic receptor agonist. Eight patients (4 men and 4 women) with refractory orthostatic hypotension resulting from autonomic failure were studied. This study was based on the notion that neurogenic orthostatic hypotension results from attenuation of adrenergic nerve traffic and not from alpha-adrenergic receptor dysfunction. Although arteriolar vasoconstrictors seem to be appropriate therapeutic agents, their success has been limited, and the search for an ideal drug is ongoing. METHODS The authors employed a blocked, double-blind, randomized crossover design. The single-blind placebo run-in period was 2 days. The double-blind titration period with either Midodrine or ephedrine was 3 to 5 days; the titration end point was to increase standing systolic blood pressure to > or = 80 mm Hg and to maintain a supine pressure below 180/100 mm Hg. The maintenance period was 3 to 5 days. A 4-day placebo washout period was interposed at the crossover point. RESULTS The ability to stand improved in patients treated with Midodrine but not with ephedrine. Midodrine significantly increased both systolic (P 0.05). Midodrine treatment improved the frequency of the ability to stand as compared with ephedrine, and was associated with a significantly higher incidence of standing systolic pressures > 80 mm Hg than was placebo (P < 0.001). Both Midodrine and ephedrine significantly increased supine systolic and diastolic blood pressures over placebo (P < 0.001, P < 0.01, P < 0.01, P < 0.01, respectively), but were not significantly different from each other. Ephedrine significantly increased (P < 0.05) the pulse rate as compared with placebo and Midodrine, whereas Midodrine produced a statistically significant (P < 0.05) but clinically minimal decrease in pulse rate compared with placebo. Neither drug affected clinical laboratory variables. CONCLUSIONS Midodrine safely and effectively improved orthostatic hypotension caused by autonomic failure. Our data suggest that the ability to stand is improved better by Midodrine than by ephedrine.

  • neurogenic orthostatic hypotension a double blind placebo controlled study with Midodrine
    The American Journal of Medicine, 1993
    Co-Authors: Joseph Jankovic, Janice L Gilden, Bradley C Hiner, Horacio Kaufmann, David C Brown, Cecil Coghlan, Michael Rubin, Fetnat M Fouadtarazi
    Abstract:

    PURPOSE: To investigate the efficacy and safety of Midodrine for treatment of patients with orthostatic hypotension due to autonomic failure. PATIENTS: Ninety-seven patients with orthostatic hypotension were randomized in a 4-week, double-blinded, placebo-controlled study with a 1-week placebo run-in period. Patients ranged in age from 22 to 86 years (mean: 61 years). METHODS: After a 1-week run-in phase, either placebo or Midodrine at a dose of 2.5 mg, 5 mg, or 10 mg was administered three times a day for 4 weeks. Both the placebo group and the 2.5-mg Midodrine group received constant doses throughout the double-blind phase. The patients receiving 5 mg or 10 mg of Midodrine were given doses that were increased at weekly intervals by 2.5-mg increments until the designated dose was reached. Efficacy evaluations were based on an improvement at 1-hour postdose in standing systolic blood pressure and in symptoms of orthostatic hypotension (syncope, dizziness/lightheadedness, weakness/fatigue, and low energy level). RESULTS: Midodrine (10 mg) increased standing systolic blood pressure by 22 mm Hg (28%, p < 0.001 versus placebo). Midodrine improved (p < 0.05) the following symptoms of orthostatic hypotension compared to placebo: dizziness/lightheadedness, weakness/fatigue, syncope, low energy level, impaired ability to stand, and feelings of depression. The overall side effects were mainly mild to moderate. One or more side effects were reported by 22% of the placebo group compared with 27% of the Midodrine-treated group. Scalp pruritus/tingling, which was reported by 10 of 74 (13.5%) of the Midodrine-treated patients, was most frequent. Other reported side effects included supine hypertension (8%) and feelings of urinary urgency (4%). CONCLUSION: We conclude that Midodrine is an effective and well-tolerated treatment for moderate-to-severe orthostatic hypotension associated with autonomic failure.