Do meals affect heart rate and symptoms in postural orthostatic tachycardia syndrome?

AbstractPostural orthostatic tachycardia syndrome (POTS) is a cardiovascular autonomic disorder with poorly understood etiology and underlying pathophysiology. Since cardiovascular morbidity has been linked to growth hormone (GH), we studied GH levels in patients with POTS. We conducted an age-sex-matched case–control study in patients with POTS (age 31 ± 9 years; n = 42) and healthy controls (32 ± 9 years; n = 46). Plasma GH levels were measured using high-sensitivity chemiluminescence sandwich immunoassay. The burden of orthostatic intolerance symptoms was assessed by the Orthostatic Hypotension Questionnaire (OHQ), consisting of a symptom assessment scale (OHSA) and a daily activity scale (OHDAS). POTS patients had significantly higher composite OHQ score than controls, more symptoms and less activity. Supine heart rate and diastolic blood pressure (BP), but not systolic BP, were significantly higher in POTS. Median plasma GH levels were significantly lower in POTS (0.53 ng/mL) than controls (2.33 ng/mL, p = 0.04). GH levels were inversely related to OHDAS in POTS and supine systolic BP in POTS and controls, but not heart rate neither group. POTS is associated with lower GH levels. Impairment of daily life activities is inversely related with GH in POTS. A higher supine diastolic BP is inversely associated with GH levels in POTS and healthy individuals.

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Abstract 222: Nerve Conduction Study in Postural Orthostatic Tachycardia Syndrome

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.9.suppl_2.222 ◽

2016 ◽

Vol 9 (suppl_2) ◽

Author(s):

Chandralekha Ashangari ◽

Samreen F Asghar ◽

Sadaf Syed ◽

Amna A Butt ◽

Amer Suleman

Keyword(s):

Heart Rate ◽

Nerve Conduction Study ◽

Nerve Conduction ◽

Clinical Symptoms ◽

Orthostatic Intolerance ◽

Tibial Nerve ◽

Sensory Nerves ◽

Exercise Intolerance ◽

Postural Orthostatic Tachycardia Syndrome ◽

Medical Diagnostic

Background: Postural orthostatic tachycardia syndrome (POTS) is an autonomic disturbance characterized by the clinical symptoms of orthostatic intolerance, mainly light headedness, fatigue, sweating, tremor, anxiety, palpitation, exercise intolerance and near syncope on upright posture. These are relieved on lying down. Patients also have a heart rate >120 beats/min (bpm) on standing or increase their heart rate by 30 bpm from a resting heart rate after standing for 10 min. A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. The aim of this study is to demonstrate median, ulnar, peroneal, tibial nerve conduction results POTS patients. Methods: 177 patients were selected randomly from our clinic with POTS. Nerve conduction results of median, ulnar, peroneal, tibial nerves were reviewed from electronic medical records. Results: Out of 177 patients, 151 patients are females (85%, n=151, age 32.07±11.10), 26 patients are males (15%, n=26, age 29.08±17.40).Median nerve conduction results are 57.83 m/sec ±7.58 m/sec, Ulnar nerve conduction results are 56.62 m/sec ±6.85 m/sec, Peroneal nerve conduction results are 49.96 m/sec ±6.85 m/sec, Tibial nerve conduction results are 50.70 m/sec ±6.86 m/sec. Conclusion: The nerve conduction velocities tend to be within normal range in Postural Orthostatic Tachycardia Syndrome (POTS) patients.

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24-Hour Heart Rate Variability in Subjects with Postural Orthostatic Tachycardia Syndrome (POTS)

Heart Lung and Circulation ◽

10.1016/j.hlc.2017.06.555 ◽

2017 ◽

Vol 26 ◽

pp. S284 ◽

Cited By ~ 1

Author(s):

A. Goff ◽

A. Patel ◽

J. Spies ◽

K. Chan ◽

I. Faulds ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Postural Orthostatic Tachycardia Syndrome

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A quantitative analysis of ventilation tachycardia and its control in two chelonians, Pseudemys scripta and Testudo graeca

Journal of Experimental Biology ◽

10.1242/jeb.63.2.367 ◽

1975 ◽

Vol 63 (2) ◽

pp. 367-380 ◽

Cited By ~ 2

Author(s):

W. W. Burggren

Keyword(s):

Heart Rate ◽

Water Immersion ◽

Lung Ventilation ◽

Heart Rate Change ◽

Vagal Activity ◽

Testudo Graeca ◽

Development Duration ◽

Pseudemys Scripta ◽

Peripheral Sensory ◽

Affect Heart Rate

1. In both the turtle, Pseudemys scripta, and the tortoise, Testudo graeca, lung ventilation is closely accompanied by a tachycardia of predictable magnitude and duration. 2. Efferent vagal activity progressively decreases as heart rate increases with the onset of lung ventilation. Atropine decreases heart rate during apnoea to those levels observed during prolonged breathing series when the development, duration or magnitude of ventilation tachycardia. It is thus concluded that heart rate change during chelonian lung ventilation is mediated solely by alterations in vagal tone. 3. Peripheral sensory reflexes involving pulmonary stretch receptors, arterial chemoreceptors and baroreceptors, and receptors stimulated by water immersion do not affect heart rate during breathing. It is suggested that ventilation tachycardia in these chelonians is the result of the spread of activity between the respiratory and cardiac centres of the medulla.

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Postural orthostatic tachycardia syndrome in primary care: diagnosis, treatment and a case of African-American man presenting with POTS

BMJ Case Reports ◽

10.1136/bcr-2019-229824 ◽

2019 ◽

Vol 12 (9) ◽

pp. e229824

Author(s):

Andrew T Del Pozzi ◽

Michael Enechukwu ◽

Svetlana Blitshteyn

Keyword(s):

Heart Rate ◽

Differential Diagnosis ◽

African American ◽

Clinical Features ◽

Orthostatic Intolerance ◽

Treatment Options ◽

Postural Orthostatic Tachycardia Syndrome ◽

Tilt Table Test ◽

Tilt Table ◽

Caucasian Women

Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous autonomic disorder characterised by orthostatic intolerance and a rise in heart rate by at least 30 bpm or an absolute heart rate value of at least 120 bpm within 10 min of standing or during a tilt table test. Overwhelmingly, POTS affects young Caucasian women, which can lead physicians to miss the diagnosis in men or non-white patients. We describe a case of 29-year-old African-American man who developed lightheadedness, generalised weakness, tachycardia and palpitations and was subsequently diagnosed with POTS. We review its clinical features, differential diagnosis, pathophysiology and treatment options. We also emphasise that POTS should be considered as a differential diagnosis in any patient presenting with typical clinical features, who may not be in the usual demographics of the disorder.

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Reduced parasympathetic control of heart rate in obese dogs

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1995.269.2.h629 ◽

1995 ◽

Vol 269 (2) ◽

pp. H629-H637 ◽

Cited By ~ 21

Author(s):

B. N. Van Vliet ◽

J. E. Hall ◽

H. L. Mizelle ◽

J. P. Montani ◽

M. J. Smith

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Rate Control ◽

Saturated Fat ◽

Pressure Control ◽

Resting Heart Rate ◽

Arterial Blood ◽

Parasympathetic Control ◽

The Mean ◽

Affect Heart Rate

We investigated why resting heart rate is elevated in dogs fed a high saturated fat diet for 12.7 +/- 1.8 wk. Obese dogs exhibited elevated body weight (59%), blood pressure (14%), and heart rate (25%). Differences in resting heart rate (control, 58 +/- 5 beats/min; obese, 83 +/- 7 beats/min) were abolished after hexamethonium, indicating an autonomic mechanism. Hexamethonium also reduced blood pressure in obese (20 +/- 4 mmHg) but not control (9 +/- 6 mmHg) animals. Propranolol did not affect heart rate in either group, excluding a beta-adrenergic mechanism. Subsequent administration of atropine increased heart rate more in control than in obese dogs (110 +/- 9 vs. 57 +/- 11 beats/min). The sensitivity of the cardiac limb of the baroreflex (Oxford method) was reduced by 46% in the obese group, confirming impairment of the parasympathetic control of heart rate. The standard deviation of blood pressure measurements was normal when expressed as a percentage of the mean arterial blood pressure (control, 11.2 +/- 0.4%; obese, 11.2 +/- 0.5%). Our results indicate that the development of obesity in dogs fed a high saturated fat diet is accompanied by an attenuated resting and reflex parasympathetic control of heart rate.

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