| A prospective, 1-year follow-up study of postural tachycardia syndrome. | |
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MedLine Citation:
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PMID: 22795533 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-07-15 |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 87 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-08-06 Completed Date: 2012-10-24 Revised Date: 2013-04-08 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: England |
Other Details:
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Languages: eng Pagination: 746-52 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Clinical Neurological Sciences, University Hospital, University of Western Ontario, London, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-1 Receptor Agonists
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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:
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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:
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0/Adrenergic alpha-1 Receptor Agonists; 0/Adrenergic beta-1 Receptor Antagonists; 0/Anti-Inflammatory Agents; 0/Cholinesterase Inhibitors; 101-26-8/Pyridostigmine Bromide; 127-31-1/Fludrocortisone; 29122-68-7/Atenolol; 37350-58-6/Metoprolol; 42200-33-9/Nadolol; 42794-76-3/Midodrine; 51-41-2/Norepinephrine; 525-66-6/Propranolol; 7440-23-5/Sodium |
| Comments/Corrections | |
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