Document Detail


A prospective, 1-year follow-up study of postural tachycardia syndrome.
MedLine Citation:
PMID:  22795533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function.
METHODS: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of ≥ 30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms.
RESULTS: Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8 ± 15.1 beats/min) compared with baseline (37.8 ± 14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year.
CONCLUSION: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.
Authors:
Kurt Kimpinski; Juan J Figueroa; Wolfgang Singer; David M Sletten; Valeria Iodice; Paola Sandroni; Philip R Fischer; Tonette L Opfer-Gehrking; Jade A Gehrking; Phillip A Low
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-15
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  87     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-06     Completed Date:  2012-10-24     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  England    
Other Details:
Languages:  eng     Pagination:  746-52     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-1 Receptor Agonists / therapeutic use
Adrenergic beta-1 Receptor Antagonists / therapeutic use
Adult
Anti-Inflammatory Agents / therapeutic use
Atenolol / therapeutic use
Cholinesterase Inhibitors / therapeutic use
Female
Fludrocortisone / therapeutic use
Follow-Up Studies
Heart Rate
Humans
Male
Metoprolol / therapeutic use
Midodrine / therapeutic use
Nadolol / therapeutic use
Norepinephrine / blood
Postural Orthostatic Tachycardia Syndrome / drug therapy,  epidemiology*
Propranolol / therapeutic use
Prospective Studies
Pyridostigmine Bromide / therapeutic use
Severity of Illness Index
Sodium / urine
Tilt-Table Test
Virus Diseases / epidemiology
Grant Support
ID/Acronym/Agency:
NS 32352/NS/NINDS NIH HHS; NS 44233/NS/NINDS NIH HHS; P01 NS044233/NS/NINDS NIH HHS; P50 NS032352/NS/NINDS NIH HHS; U54 NS065736/NS/NINDS NIH HHS; U54 NS065736/NS/NINDS NIH HHS; UL1 RR24150/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic alpha-1 Receptor Agonists; 0/Adrenergic beta-1 Receptor Antagonists; 0/Anti-Inflammatory Agents; 0/Cholinesterase Inhibitors; 42200-33-9/Nadolol; 50VV3VW0TI/Atenolol; 6YE7PBM15H/Midodrine; 9NEZ333N27/Sodium; 9Y8NXQ24VQ/Propranolol; GEB06NHM23/Metoprolol; KVI301NA53/Pyridostigmine Bromide; U0476M545B/Fludrocortisone; X4W3ENH1CV/Norepinephrine
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