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已发表论文
肾素 - 血管紧张素 - 醛固酮系统活性水平与体位性心动过速综合征患儿灌注指数的相关性
Authors Zhang F , Pan J, Lin Z, Niu M
Received 11 July 2025
Accepted for publication 24 October 2025
Published 6 November 2025 Volume 2025:21 Pages 927—936
DOI https://doi.org/10.2147/VHRM.S553129
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Pietro Scicchitano
Fengling Zhang, Jinyong Pan, Zhaotang Lin, Muqing Niu
Department of Pediatrics, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang Uygur Autonomous Region, People’s Republic of China
Correspondence: Jinyong Pan, Department of Pediatrics, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang Uygur Autonomous Region, People’s Republic of China, Email 63620441@qq.com
Objective: To evaluate the relationship between Renin-Angiotensin-Aldosterone System (RAAS) activity and Perfusion Index (PI) in children with Postural Tachycardia Syndrome (POTS), and to assess the diagnostic performance of Angiotensin II (AngII) and PI for POTS status.
Methods: A total of 65 children with POTS and 65 age- and sex-matched healthy controls were enrolled. Plasma renin, angiotensin I (AngI), AngII, and aldosterone were quantified via enzyme-linked immunosorbent assay, and PI was measured using a pulse oximetry-based monitor during head-up tilt testing. Statistical analyses included Receiver Operating Characteristic (ROC) curve analysis of AngII and PI for POTS status, binary logistic regression, and Pearson correlation.
Results: Compared to controls, children with POTS demonstrated a significantly lower PI (4.64 ± 1.54 vs 6.19 ± 1.64%; adjusted p < 0.005) and higher AngII levels (114.07 ± 7.69 vs 109.20 ± 10.44 pg/mL; adjusted p = 0.012). ROC analysis indicated that PI had a stronger diagnostic value (AUC = 0.753, 95% CI: 0.670– 0.836) than AngII (AUC = 0.654, 95% CI: 0.559– 0.749) in identifying POTS. In logistic regression, only PI remained an independent predictor of POTS (Odds Ratio = 0.577, 95% CI: 0.442– 0.755, p < 0.001). A significant inverse correlation was observed between AngII and PI (r = – 0.459, p < 0.001).
Conclusions: PI is a valuable, noninvasive clinical marker for POTS in children, demonstrating superior diagnostic utility compared to AngII. While elevated AngII retains clinical significance by reflecting underlying pathophysiology and disease severity, its independent predictive value is limited. The combined assessment of PI and AngII may enhance the pathophysiological understanding and management strategies for pediatric POTS.
Keywords: postural tachycardia syndrome in children, renin-angiotensin-aldosterone system, perfusion index
Department of Pediatrics, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang Uygur Autonomous Region, People’s Republic of China
Correspondence: Jinyong Pan, Department of Pediatrics, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang Uygur Autonomous Region, People’s Republic of China, Email 63620441@qq.com
Objective: To evaluate the relationship between Renin-Angiotensin-Aldosterone System (RAAS) activity and Perfusion Index (PI) in children with Postural Tachycardia Syndrome (POTS), and to assess the diagnostic performance of Angiotensin II (AngII) and PI for POTS status.
Methods: A total of 65 children with POTS and 65 age- and sex-matched healthy controls were enrolled. Plasma renin, angiotensin I (AngI), AngII, and aldosterone were quantified via enzyme-linked immunosorbent assay, and PI was measured using a pulse oximetry-based monitor during head-up tilt testing. Statistical analyses included Receiver Operating Characteristic (ROC) curve analysis of AngII and PI for POTS status, binary logistic regression, and Pearson correlation.
Results: Compared to controls, children with POTS demonstrated a significantly lower PI (4.64 ± 1.54 vs 6.19 ± 1.64%; adjusted p < 0.005) and higher AngII levels (114.07 ± 7.69 vs 109.20 ± 10.44 pg/mL; adjusted p = 0.012). ROC analysis indicated that PI had a stronger diagnostic value (AUC = 0.753, 95% CI: 0.670– 0.836) than AngII (AUC = 0.654, 95% CI: 0.559– 0.749) in identifying POTS. In logistic regression, only PI remained an independent predictor of POTS (Odds Ratio = 0.577, 95% CI: 0.442– 0.755, p < 0.001). A significant inverse correlation was observed between AngII and PI (r = – 0.459, p < 0.001).
Conclusions: PI is a valuable, noninvasive clinical marker for POTS in children, demonstrating superior diagnostic utility compared to AngII. While elevated AngII retains clinical significance by reflecting underlying pathophysiology and disease severity, its independent predictive value is limited. The combined assessment of PI and AngII may enhance the pathophysiological understanding and management strategies for pediatric POTS.
Keywords: postural tachycardia syndrome in children, renin-angiotensin-aldosterone system, perfusion index