{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:07:35Z","timestamp":1788955655147,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Recent cardiovascular literature suggests that orthostatic testing protocols should be tailored according to diagnostic purpose, distinguishing syncope evaluation from assessment of autonomic dysfunction in chronic orthostatic intolerance (COI). In adults, autonomic testing is commonly interpreted within a 10\u2010min observation period, such as the active stand test. However, no specific time\u2010based protocol has been clearly established for paediatric groups. This study examined whether a 10\u2010min head\u2010up tilt table test (HUTT) provides sufficient diagnostic yield in paediatric COI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively screened 410 paediatric patients who underwent a 30\u2010min, non\u2010pharmacological HUTT between 2008 and 2024, of whom 97 were included in the final cohort after excluding syncope\u2010only presentations and other underlying diseases. Positive responses were classified as orthostatic hypotension, postural orthostatic tachycardia syndrome or vasovagal syncope. Cumulative positivity rates were compared across 10\u2010, 20\u2010 and 30\u2010min intervals, and time to first positive response was analysed by COI subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cumulative positivity increased with longer testing, from 25.8% at 10\u2009min to 44.3% at 20\u2009min and 55.6% at 30\u2009min.\u00a0Median time to positivity was 14\u2009min overall, occurring later in orthostatic hypotension and vasovagal syncope than in postural orthostatic tachycardia syndrome. A substantial proportion of positive responses occurred beyond the first\u00a010\u2009min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In paediatric COI, a 10\u2010min HUTT may be insufficient to detect diagnostically relevant haemodynamic responses. These findings suggest that future studies of paediatric COI may need to consider orthostatic testing protocols with a minimum duration of 20\u2009min to optimise diagnostic yield.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70560","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:30:12Z","timestamp":1788953412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tilt Table Testing in\n                    <scp>Paediatric<\/scp>\n                    Orthostatic Intolerance: Is 10\u2009Min Long Enough?"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8850-6318","authenticated-orcid":false,"given":"Wonshik","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Pediatrics Chung\u2010Ang University Hospital  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-703X","authenticated-orcid":false,"given":"Sin Weon","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Chung\u2010Ang University Hospital  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1673"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly188"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.029"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12895"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00266.2012"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy071"},{"key":"e_1_2_11_9_1","first-page":"1558","article-title":"Guideline for Diagnosis and Treatment of Syncope in Children and Adolescents","volume":"63","author":"Chinese Pediatric Cardiology Society","year":"2018","journal-title":"Science 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