Evidence map›Paper›PMID 41335326›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2026

Hemodynamic and cerebral oxygenation predictors of visual darkening in pediatric POTS: a cross-sectional study.

Soken Go, Akiko Kasuga, Kanako Hayashi, Misako Murakami, Saori Minami, Wakako Matsumoto, Ryo Takahashi, Yusuke Watanabe, Naoko Saito, Koko Ohno and 8 more

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Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Soken GoDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan. soupei@tokyo-med.ac.jp.ORCID http://orcid.org/0000-0003-0940-0273
Akiko KasugaDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Kanako HayashiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Misako MurakamiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Saori MinamiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Wakako MatsumotoDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Ryo TakahashiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Yusuke WatanabeDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Naoko SaitoDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Koko OhnoDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Natsumi MorishitaDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Mika TakeshitaDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Shinichiro MorichiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Yu IshidaDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Chiako IshiiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Naoko KinjoDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Yasuyo KashiwagiDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.
Gaku YamanakaDepartment of Pediatrics and Adolescent Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-Ku, Tokyo, 160-0023, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn pediatric postural tachycardia syndrome (POTS), presyncope is important yet undercharacterized. It undermines school participation and daily function, while objective bedside markers remain limited. We aimed to delineate clinically usable predictors by integrating cardiovascular responses and cerebral oxygenation during active standing. We operationalized presyncope as visual darkening and examined three physiological correlates: heart rate change (ΔHR), recovery time, and cerebral oxygenation (ΔOxyHb).

methodsWe conducted a cross-sectional study of 49 pediatric patients with POTS (median age 14.2 years, 46.9% male). Continuous heart rate, blood pressure, and cerebral oxygenation were recorded during a 10-min active standing test; body mass index, inferior vena cava collapsibility index, and urinary sodium were also obtained. Robust regression identified independent predictors of visual darkening.

resultsΔHR emerged as the strongest predictor of visual darkening (coefficient 0.017, 95% CI 0.005-0.030, p = 0.004), followed by recovery time (coefficient 0.005, 95% CI 0.000-0.010, p = 0.055) and ΔOxyHb (coefficient 0.029, 95% CI  - 0.005 to 0.064, p = 0.098). The final model demonstrated strong discriminative ability (AUC 0.842). Patients reporting visual darkening exhibited significantly higher ΔHR (49 [42-59] vs. 41 [38-46] bpm, p = 0.009), longer recovery time (21 [19-28] vs. 19 [17-22] s, p = 0.041), and greater ΔOxyHb reduction (- 8.7 [ - 10.4 to - 2.4] vs. - 3.5 [- 7.0 to - 2.5] μmol/L, p = 0.039).

conclusionsHeart rate change upon standing is the most significant and clinically accessible predictor of visual darkening in pediatric POTS. The combined assessment of ΔHR, recovery time, and cerebral oxygenation offers a comprehensive evaluation of the risk of visual darkening, enabling personalized management strategies for pediatric patients.

Indexed as

BrainHemodynamicsPostural Orthostatic Tachycardia SyndromeAdolescentBlood PressureChildCross-Sectional StudiesFemaleHeart RateHumansMaleCerebral oxygenationHeart ratePediatricPostural tachycardia syndromeVisual darkening

Identifiers

PMID41335326

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.