Document Detail


Diurnal variability in orthostatic tachycardia: implications for the postural tachycardia syndrome.
MedLine Citation:
PMID:  21751966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with POTS (postural tachycardia syndrome) have excessive orthostatic tachycardia (>30 beats/min) when standing from a supine position. HR (heart rate) and BP (blood pressure) are known to exhibit diurnal variability, but the role of diurnal variability in orthostatic changes of HR and BP is not known. In the present study, we tested the hypothesis that there is diurnal variation of orthostatic HR and BP in patients with POTS and healthy controls. Patients with POTS (n=54) and healthy volunteers (n=26) were admitted to the Clinical Research Center. Supine and standing (5 min) HR and BP were obtained in the evening on the day of admission and in the following morning. Overall, standing HR was significantly higher in the morning (102±3 beats/min) than in the evening (93±2 beats/min; P<0.001). Standing HR was higher in the morning in both POTS patients (108±4 beats/min in the morning compared with 100±3 beats/min in the evening; P=0.012) and controls (89±3 beats/min in the morning compared with 80±2 beats/min in the evening; P=0.005) when analysed separately. There was no diurnal variability in orthostatic BP in POTS. A greater number of subjects met the POTS HR criterion in the morning compared with the evening (P=0.008). There was significant diurnal variability in orthostatic tachycardia, with a great orthostatic tachycardia in the morning compared with the evening in both patients with POTS and healthy subjects. Given the importance of orthostatic tachycardia in diagnosing POTS, this diurnal variability should be considered in the clinic as it may affect the diagnosis of POTS.
Authors:
Jordan A Brewster; Emily M Garland; Italo Biaggioni; Bonnie K Black; John F Ling; Cyndya A Shibao; David Robertson; Satish R Raj
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  122     ISSN:  1470-8736     ISO Abbreviation:  Clin. Sci.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-09-13     Completed Date:  2011-12-02     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  25-31     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology
Circadian Rhythm / physiology*
Epinephrine / blood
Female
Heart Rate / physiology
Hemodynamics / physiology
Humans
Male
Norepinephrine / blood
Postural Orthostatic Tachycardia Syndrome / blood,  physiopathology*
Posture / physiology*
Supine Position / physiology
Tachycardia / physiopathology*
Grant Support
ID/Acronym/Agency:
1 UL1 RR024975/RR/NCRR NIH HHS; K23 RR020783/RR/NCRR NIH HHS; K23 RR020783/RR/NCRR NIH HHS; K23 RR020783-05/RR/NCRR NIH HHS; KL2 RR024977/RR/NCRR NIH HHS; KL2 TR000446/TR/NCATS NIH HHS; P01 HL056693/HL/NHLBI NIH HHS; P01 HL056693-15/HL/NHLBI NIH HHS; P01 HL56693/HL/NHLBI NIH HHS; R01 HL071784/HL/NHLBI NIH HHS; R01 HL071784/HL/NHLBI NIH HHS; R01 HL071784-08/HL/NHLBI NIH HHS; R01 HL102387/HL/NHLBI NIH HHS; R01 HL102387/HL/NHLBI NIH HHS; R01 HL102387-01A1/HL/NHLBI NIH HHS; R01 NS055670/NS/NINDS NIH HHS; R01 NS055670/NS/NINDS NIH HHS; R01 NS055670-04/NS/NINDS NIH HHS; TL1 RR024978/RR/NCRR NIH HHS; TL1 TR000447/TR/NCATS NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975-03S4/RR/NCRR NIH HHS; UL1 TR000445/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
X4W3ENH1CV/Norepinephrine; YKH834O4BH/Epinephrine
Comments/Corrections

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