Usefulness of Plasma Copeptin as a Biomarker to Predict the Therapeutic Effectiveness of Metoprolol for Postural Tachycardia Syndrome in Children
Abstract
Metoprolol is clinically used to treat postural tachycardia syndrome (POTS) in children, but its effectiveness is unsatisfactory. Biomarkers to predict therapeutic efficacy are needed. We aimed to explore changes in the plasma copeptin level for assessing the therapeutic efficacy of metoprolol for POTS in children. We included 49 children with POTS and 25 healthy children as controls. Patients received metoprolol for 1.5 to 3 months. The plasma copeptin level was measured by sandwich immunoluminometric assay. The area under the receiver operating characteristic curve was used to explore the predictive value of the plasma copeptin level. The baseline plasma copeptin level was higher in children with POTS than controls (10.524 ± 2.016 vs 8.750 ± 1.419 pmol/L, p <0.001) and was lower for responders than nonresponders to metoprolol (9.377 ± 1.411 vs 12.054 ± 1.662 pmol/L, p = 0.003). The area under the receiver operating characteristic curve was 0.889 (95% confidence interval 0.799 to 0.980). With a baseline plasma copeptin level of 10.225 pmol/L as a cutoff, the sensitivity was 90.5% and specificity 78.6% in predicting the efficacy of metoprolol in children with POTS. In conclusion, the baseline plasma copeptin level can be used as a biomarker to predict the therapeutic effectiveness of metoprolol in children with POTS.
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In certain cases, it may be possible to recognize key endophenotypes in POTS.
“In certain cases, it may be possible to recognize key endophenotypes (13, 73, 79).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [79]
POTS patients with low copeptin levels were far more likely to respond to metoprolol than those with high copeptin levels.
“Zhao et al. (79) demonstrated that POTS patients with low copeptin levels were far more likely to respond to metoprolol than those with high levels of copeptin, presumably due to a greater contribution of the hyperadrenergic endophenotype to their syndrome.”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [79]
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- Authors
- Zhao, J., Du, S., Yang, J., Lin, J., Tang, C., Du, J., & Jin, H.
- Affiliations
- Peking University First Hospital (CN)
- Capital Medical University (CN)
- Ministry of Education of the People's Republic of China (CN)
- Corresponding author
- Jin, Hongfang
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 114
- Issue
- 4
- Pages
- 601-605
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2057908896
- Cited by
- 41
- References
- 4
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 2
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, metoprolol, copeptin, plasma biomarkers, treatment response prediction, children, beta-blocker therapy
- MeSH terms
- Adolescent, Anti-Arrhythmia Agents, Child, Dose-Response Relationship, Drug, Electrocardiography, Female, Follow-Up Studies, Glycopeptides, Heart Rate, Humans, Male, Metoprolol, Posture, Predictive Value of Tests, Protein Precursors, ROC Curve, Biomarkers, Treatment Outcome, Postural Orthostatic Tachycardia Syndrome
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