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Orthostatic Intolerance

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Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment.

Brian Olshansky, David Cannom, Artur Fedorowski, Julian Stewart, Christopher Gibbons, Richard Sutton, Win-Kuang Shen, James Muldowney, Tae Hwan Chung, Suzy Feigofsky, Hemal Nayak, Hugh Calkins, David G Benditt,

Although diagnostic criteria have been developed characterizing postural orthostatic tachycardia syndrome (POTS), no single set of criteria is universally accepted. Furthermore, there are gaps in the present criteria to identify individuals who have this condition. The reproducibility of the physiological findings, the relationship of symptoms to physiological findings, the presence ... Read more >>

Prog Cardiovasc Dis (Progress in cardiovascular diseases)
[2020, :]

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Symptom Recognition Is Impaired in Patients With Orthostatic Hypotension.

Roy Freeman, Ben M W Illigens, Razvan Lapusca, Marta Campagnolo, Ahmad R Abuzinadah, Istvan Bonyhay, Dong-In Sinn, Mitchell Miglis, Jeffrey White, Christopher H Gibbons,

Failure to recognize symptoms of orthostatic hypotension (OH) may result in falls, syncope, and injuries. The relationship between orthostatic changes in blood pressure and symptom occurrence and severity is not known. The goal of the present study was to define the relationship between the occurrence and severity of the symptoms ... Read more >>

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2020, :HYPERTENSIONAHA11913619]

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Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance.

Satish R Raj, Juan C Guzman, Paula Harvey, Lawrence Richer, Ronald Schondorf, Colette Seifer, Nicolas Thibodeau-Jarry, Robert S Sheldon,

The current definition of postural orthostatic tachycardia syndrome (POTS) dates back to a small case series of patients with a subacute illness who presented with excessive orthostatic tachycardia and orthostatic intolerance, in the absence of another recognized disease. Conventional POTS criteria require an excessive orthostatic tachycardia in the absence of ... Read more >>

Can J Cardiol (The Canadian journal of cardiology)
[2020, 36(3):357-372]

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Effect of a neck compression collar on cardiorespiratory and cerebrovascular function in Postural Orthostatic Tachycardia Syndrome (POTS).

Massimo Nardone, Juan Guzman, Paula Jean Harvey, John S Floras, Heather Edgell,

Postural orthostatic tachycardia syndrome (POTS) is accompanied by reduced brain blood flow, autonomic dysfunction, and orthostatic intolerance. We hypothesized that wearing a neck compression collar would attenuate orthostatic symptoms, increase brain blood flow, and influence autonomic reflexes. Ten participants with POTS (9 women, age: 36±10) underwent two trials of supine ... Read more >>

J. Appl. Physiol. (Journal of applied physiology (Bethesda, Md. : 1985))
[2020, :]

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Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography.

C Linda M C van Campen, Freek W A Verheugt, Peter C Rowe, Frans C Visser,

Objective:The underlying hypothesis in orthostatic intolerance (OI) syndromes is that symptoms are associated with cerebral blood flow (CBF) reduction. Indirect CBF measurements (transcranial Doppler flow velocities), provide inconsistent support of this hypothesis. The aim of the study was to measure CBF during a 30 min head-up tilt test (HUT), using Doppler ... Read more >>

Clin Neurophysiol Pract (Clinical neurophysiology practice)
[2020, 5:50-58]

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Classical and Delayed Orthostatic Hypotension in Patients With Unexplained Syncope and Severe Orthostatic Intolerance.

Parisa Torabi, Fabrizio Ricci, Viktor Hamrefors, Richard Sutton, Artur Fedorowski,

Background: Orthostatic hypotension (OH) is a major sign of cardiovascular autonomic failure leading to orthostatic intolerance and syncope. Orthostatic hypotension is traditionally divided into classical OH (cOH) and delayed OH (dOH), but the differences between the two variants are not well-studied. We performed a systematic clinical and neuroendocrine characterization of ... Read more >>

Front Cardiovasc Med (Frontiers in cardiovascular medicine)
[2020, 7:21]

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Postural Orthostatic Tachycardia Syndrome.

Payam Safavi-Naeini, Mehdi Razavi,

Tex Heart Inst J (Texas Heart Institute journal)
[2020, 47(1):57-59]

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Transient Orthostatic Hypertension During Head-Up Tilt Test in Young Adults: A Phenotype of Blood Pressure Variability.

Álvaro Petersen, Cecy Salas-Herrera, Claudia Lerma, Christopher Brown-Escobar, Andrei Kostin, Manuel Sierra-Beltrán, J Antonio González-Hermosillo,

PURPOSE:The mechanisms underlying orthostatic hypertension (OHT) remain poorly understood. The authors evaluated the cardiovascular, cerebrovascular dynamics, and autonomic response to head-up tilt test (HUTT) in young adults with symptoms of orthostatic intolerance and transient OHT. METHODS:Forty-four female subjects were included (34 ± 13 years old) and categorized in three groups ... Read more >>

J Clin Neurophysiol (Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society)
[2020, :]

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Postural Tachycardia Syndrome and Neurally Mediated Syncope.

Jeremy K Cutsforth-Gregory,

PURPOSE OF REVIEW:This article reviews the diagnosis and management of the most common disorders of orthostatic intolerance: postural tachycardia syndrome (POTS) and neurally mediated syncope. RECENT FINDINGS:POTS is a heterogeneous syndrome caused by several pathophysiologic mechanisms that may coexist (limited autonomic neuropathy, hyperadrenergic state, hypovolemia, venous pooling, joint hypermobility, deconditioning). ... Read more >>

Continuum (Minneap Minn) (Continuum (Minneapolis, Minn.))
[2020, 26(1):93-115]

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Functional Gastrointestinal Disorders, Autonomic Nervous System Dysfunction, and Joint Hypermobility in Children: Are They Related?

Carlos Alberto Velasco-Benitez, Cara Axelrod, Lilibet Fernandez Valdes, Miguel Saps,

OBJECTIVES:To evaluate the prevalence of orthostatic intolerance and joint hypermobility in schoolchildren with and without functional gastrointestinal disorders (FGIDs) and to assess autonomic nervous system dysfunction in children with FGIDs and joint hypermobility. STUDY DESIGN:Schoolchildren (10-18 years) attending public schools from 3 Colombian cities (Cali, Palmira, and Bucaramanga) completed validated questionnaires ... Read more >>

J. Pediatr. (The Journal of pediatrics)
[2020, 218:114-120.e3]

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Peripheral endothelial dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome.

Nadja Scherbakov, Marvin Szklarski, Jelka Hartwig, Franziska Sotzny, Sebastian Lorenz, Antje Meyer, Patricia Grabowski, Wolfram Doehner, Carmen Scheibenbogen,

AIMS:Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex multisystem disease. Evidence for disturbed vascular regulation comes from various studies showing cerebral hypoperfusion and orthostatic intolerance. The peripheral endothelial dysfunction (ED) has not been sufficiently investigated in patients with ME/CFS. The aim of the present study was to examine peripheral endothelial ... Read more >>

ESC Heart Fail (ESC heart failure)
[2020, :]

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Correction to: Analysis of autonomic outcomes in APOLLO, a phase III trial of the RNAi therapeutic patisiran in patients with hereditary transthyretin-mediated amyloidosis.

Alejandra González-Duarte, John L Berk, Dianna Quan, Michelle L Mauermann, Hartmut H Schmidt, Michael Polydefkis, Márcia Waddington-Cruz, Mitsuharu Ueda, Isabel M Conceição, Arnt V Kristen, Teresa Coelho, Cécile A Cauquil, Céline Tard, Madeline Merkel, Emre Aldinc, Jihong Chen, Marianne T Sweetser, Jing Jing Wang, David Adams,

The original version of this article unfortunately contained a mistake. ... Read more >>

J. Neurol. (Journal of neurology)
[2020, 267(3):713-714]

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Behçet's Disease with Severe Autonomic Disorders Developing after Herpes Zoster.

Serina Koto, Masataka Umeda, Hiroaki Kawano, Yushiro Endo, Toshimasa Shimizu, Tomohiro Koga, Kunihiro Ichinose, Hideki Nakamura, Akihiro Mukaino, Osamu Higuchi, Shunya Nakane, Atsushi Kawakami,

A 58-year-old Japanese woman with herpes zoster developed Behçet's disease (BD) with symptoms including orthostatic intolerance as an autonomic disorder. Multiple immune-suppressive therapies and a β-blocker successfully controlled both the disease activity of BD and the autonomic disorders. A cytokine multiplex analysis of her serum revealed the elevation of proinflammatory ... Read more >>

Intern. Med. (Internal medicine (Tokyo, Japan))
[2020, :]

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Arterial Elasticity in Ehlers-Danlos Syndromes.

Amanda J Miller, Jane R Schubart, Timothy Sheehan, Rebecca Bascom, Clair A Francomano,

Ehlers-Danlos Syndromes (EDS) are a group of heritable disorders of connective tissue (HDCT) characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Orthostatic intolerance (OI) is highly prevalent in EDS however mechanisms linking OI to EDS remain poorly understood. We hypothesize that impaired blood pressure (BP) and heart rate control ... Read more >>

Genes (Basel) (Genes)
[2020, 11(1):]

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Sympathetic nervous activity and hemoglobin levels in de novo Parkinson's disease.

Tadashi Umehara, Hisayoshi Oka, Atsuo Nakahara, Tomotaka Shiraishi, Takeo Sato, Hiromasa Matsuno, Teppei Komatsu, Shusaku Omoto, Hidetomo Murakami, Yasuyuki Iguchi,

PURPOSE:Sympathetic nervous denervation may be associated with the development of anemia. We aimed to investigate the association between sympathetic nervous denervation and hemoglobin levels in patients with Parkinson's disease (PD). METHODS:As indices of sympathetic nervous denervation, we investigated resting norepinephrine levels, increased norepinephrine levels after tilt-up, cardiac uptake of 123I-metaiodobenzylguanidine, ... Read more >>

Clin. Auton. Res. (Clinical autonomic research : official journal of the Clinical Autonomic Research Society)
[2020, :]

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High Submaximal Exercise Heart Rate Impacts Exercise Intolerance in the Postural Orthostatic Tachycardia Syndrome.

Erik H Van Iterson, Luke J Laffin, Kenneth A Mayuga, Erika Hutt Centeno, Taha Ahmed, Leslie Cho, Haitham M Ahmed,

PURPOSE:Exercise intolerance is a hallmark of the postural orthostatic tachycardia syndrome (POTS). However, no data are available on the implications of an exaggerated submaximal heart rate (HR) on exercise intolerance in patients. We investigated whether exaggerated HR responses occurring early on during incremental stress testing relate with increased odds of ... Read more >>

J Cardiopulm Rehabil Prev (Journal of cardiopulmonary rehabilitation and prevention)
[2020, :]

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Sympathetic Overactivation From Supine to Upright Is Associated With Orthostatic Hypertension in Children and Adolescents.

Yang Hu, Yuanyuan Wang, Bing He, Yaru Wang, Zhenhui Han, Chunyan Tao, Hongxia Li, Yi Jiang, Chaoshu Tang, Junbao Du,

There are no prior publications or submissions with any overlapping information, including studies and patients. The study data have not been presented as an abstract or poster before the submission. Objectives: The study was conducted to analyze the changes of baroreflex sensitivity and heart rate variability from supine to upright ... Read more >>

Front Pediatr (Frontiers in pediatrics)
[2020, 8:54]

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A New Method for Assessment of Upright Posture Intolerance.

Adnan I Qureshi,

Background:Upright posture intolerance can be seen in a variety of diseases but the current methodology is not quantifiable and limits the ability to identify response to treatment. Methods:A standard questionnaire was developed to assess the following aspects of upright posture tolerance: (1) How long can you stand straight without any ... Read more >>

J Vasc Interv Neurol (Journal of vascular and interventional neurology)
[2020, 11(1):42-45]

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Management of orthostatic intolerance in children: the state of the art.

Chun-Yan Tao, Hong-Fang Jin, Jun-Bao Du,

World J Pediatr (World Journal of Pediatrics)
[2020, :]

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The incidence of orthostatic intolerance after bariatric surgery.

James B Zhang, Robyn A Tamboli, Vance L Albaugh, David B Williams, Donna M Kilkelly, Carlos G Grijalva, Cyndya A Shibao,

Aims:Every year, over 200 000 individuals undergo bariatric surgery for the treatment of extreme obesity in the United States. Several retrospective studies describe the occurrence of orthostatic intolerance (OI) syndrome after bariatric surgery. However, the incidence of this syndrome remains unknown. Materials and methods:We used a prospective, de-identified registry of ... Read more >>

Obes Sci Pract (Obesity science & practice)
[2020, 6(1):76-83]

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Enhanced postoperative recovery: good from afar, but far from good?

H Kehlet,

Enhanced postoperative recovery programmes (ERAS) were developed about 20 years ago based on improved understanding of the pathophysiology of postoperative recovery within an integrated multidisciplinary approach. The results across surgical procedures have been extremely positive with a reduction in hospitalisation and medical complications, without increased re-admission rates. However, several challenges lie ... Read more >>

Anaesthesia (Anaesthesia)
[2020, 75 Suppl 1:e54-e61]

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Cerebral Oximetry in Syncope and Syndromes of Orthostatic Intolerance.

Isabella Kharraziha, Hannes Holm, Erasmus Bachus, Fabrizio Ricci, Richard Sutton, Artur Fedorowski, Viktor Hamrefors,

Cerebral autoregulation is crucial for maintaining cerebral blood flow and perfusion. In recent years, the importance of cerebral oxygenation in syncope and orthostatic intolerance (OI) has received increased attention. Cerebral tissue oxygenation can be measured by using near-infrared spectroscopy (NIRS), which determines the ratio of oxygenated hemoglobin to total hemoglobin ... Read more >>

Front Cardiovasc Med (Frontiers in cardiovascular medicine)
[2019, 6:171]

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Consequences of the evolutionary cardiovascular challenge of human bipedalism: orthostatic intolerance syndromes, orthostatic hypertension.

Murray Esler, Stevo Julius, Benjamin Coghlan, Carolina Ika Sari, Ling Guo, Danielle Esler,

: In quadrupeds, the arterial baroreflex has dominance in the reflex homeostatic responses, which protect against haemorrhage. In humans, it is the low pressure cardiopulmonary reflex, which protects against the analogous cardiovascular challenge of gravity-dependent venous pooling with standing. To preserve orthostatic cardiovascular homeostasis with the emergence of bipedalism in ... Read more >>

J. Hypertens. (Journal of hypertension)
[2019, 37(12):2333-2340]

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Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis.

Joel Swai, Zixuan Hu, Xiexiong Zhao, Tibera Rugambwa, Gui Ming,

BACKGROUND:A number of published literature has reported that, physiologically, heart rate variability (HRV) in patients with postural orthostatic tachycardia syndrome (POTS) to be greatly confounded by age, sex, race, physical fitness, and circadian rhythm. The purpose of this study was to compare between POTS patients versus healthy participants, in terms ... Read more >>

BMC Cardiovasc Disord (BMC cardiovascular disorders)
[2019, 19(1):320]

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Prevalence and factors related to orthostatic syndromes in recently diagnosed, drug-naïve patients with Parkinson disease.

Cecilia Quarracino, Matilde Otero-Losada, Francisco Capani, Santiago Pérez-Lloret,

PURPOSE:The aim of this study was to explore the prevalence of and factors related to orthostatic syndromes in recently diagnosed drug-naïve patients with Parkinson disease (PD). METHODS:This was a cross-sectional study that included 217 drug-naïve patients with PD and 108 sex- and age-matched non-parkinsonian controls from the Parkinson's Progression Markers ... Read more >>

Clin. Auton. Res. (Clinical autonomic research : official journal of the Clinical Autonomic Research Society)
[2019, :]

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