scholarly journals Association of angiotensin II levels in patients of vasovagal syncope and postural tachycardia syndrome.

2019 ◽  
Vol 26 (08) ◽  
pp. 1218-1221
Author(s):  
Hammad Raziq ◽  
Humaira Fayyaz Khan ◽  
Noman Sadiq ◽  
Muhammad Athar Abdullah Baig ◽  
Azmat Hayyat
Keyword(s):  
Angiotensin Ii ◽  
Vasovagal Syncope ◽  
Previous History ◽  
Cerebral Hypoperfusion ◽  
Tilt Test ◽  
Control Group ◽  
Postural Tachycardia Syndrome ◽  
P Value ◽  
Cross Sectional ◽  
Postural Tachycardia

Syncope occurs as a result of cerebral hypoperfusion. Various neuroendocrine hormones have some role in the pathogenesis of Syncope. Current study was conducted to determine the role of Angiotensin II in pathophysiology of vasovagal syncope (VVS) and Postural tachycardia syndrome (POTS). Study Design: Cross sectional analytical study. Setting: Islamic International Medical College, Rawalpindi and in Electrophysiology department (AFIC). Period: April 2017 to April 2018. Material and Methods: Sample size of this study was comprises of 80 subjects, having 35 cases of VVS and POTS each and 10 controls were also taken. Cases were collected on the basis of Head up tilt test (HUT) result and on their previous history of syncope, then their blood samples were collected and stored. Hormonal analysis of Angiotensin II was performed by ELISA technique. SPSS statistics 21 was used to evaluate result by applying ANOVA test. p value of < 0.05 was considered significant. Result: Analysis of Angiotensin II concentration in Postural tachycardia syndrome, Vasovagal and control group was found 170.93 ± 118.59 pg/ml, 152.16 ± 91.40 pg/ml and 136.93 ± 43.18 pg/ml respectively. In statistical analysis p value was 0.570 which is insignificant. Conclusion: It is concluded that Angiotensin II exerts role in the pathophysiology of VVS and POTS as shown by the difference in the value of Angiotensin II in VVS, POTS and in control group.

scholarly journals Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Humaira Fayyaz ◽  
Shazadi Ambreen ◽  
Hammad Raziq ◽  
Azmat Hayyat
Keyword(s):  
Vasovagal Syncope ◽  
Serum Cortisol ◽  
Tilt Test ◽  
Control Group ◽  
Postural Tachycardia Syndrome ◽  
P Value ◽  
Cross Sectional ◽  
Postural Tachycardia ◽  
Significant Difference ◽  
Cortisol Levels

Objectives: To compare the levels of cortisol in patients of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS). Methods: A cross-sectional analytical study was conducted at Islamic International Medical College, Rawalpindi and Electrophysiology Department at (AFIC). This study included 80 subjects, comprising of 35 patients in each group of vasovagal syncope and postural tachycardia syndrome and 10 healthy subjects. Patients with complaint of syncope was evaluated for vasovagal syncope and postural tachycardia syndrome using Head Up Tilt Test (HUTT). Blood samples of all the participants were taken and serum cortisol was analyzed using ELISA method. Results were analyzed on SPSS Statistics 21 using ANOVA with a p-value of ≤0.05 regarded as significant. Results: Hormonal analysis shows that cortisol levels in the vasovagal, postural tachycardia syndrome and in control group was 153±16.7pg/ml, 160.17±pg/ml, and 69.65±5.8pg/ml respectively. Cortisol levels were significantly higher in both vasovagal and POTS groups as compared to controls with a p-value of 0.04 and 0.023 respectively. However, there was no significant difference between vasovagal and POTS patients with p value 0.570. Conclusion: It is concluded from the study that cortisol responses of VVS and POTS were positive. doi: https://doi.org/10.12669/pjms.38.1.4122 How to cite this:Khan HF, Ambreen S, Raziq H, Hayat A. Comparison of cortisol levels in patients with vasovagal syncope and postural tachycardia syndrome. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4122 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Assessment of therapeutic biomarkers in the treatment of children with postural tachycardia syndrome and vasovagal syncope

2014 ◽  
Vol 24 (5) ◽  
pp. 792-796 ◽  
Author(s):  
Jing Lin ◽  
Hongfang Jin ◽  
Junbao Du
Keyword(s):  
Orthostatic Intolerance ◽  
Vasovagal Syncope ◽  
Urinary Sodium Excretion ◽  
Tilt Test ◽  
Postural Tachycardia Syndrome ◽  
Postural Tachycardia ◽  
Ovid Medline ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Flow Mediated Vasodilation

AbstractBackground: Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. The supplementation with water, or salt, or midodrine, or β-blocker was applied to children with postural tachycardia syndrome or vasovagal syncope. However, the efficacy of such medication varied and was not satisfied. This review aimed to summarise the current biomarkers in the treatment of the diseases. Data sources: Studies were collected from online electronic databases, including OVID Medline, PubMed, ISI Web of Science, and associated references. The main areas assessed in the included studies were clinical improvement, the cure rate, and the individualised treatment for postural tachycardia syndrome and vasovagal syncope in children. Results: Haemodynamic change during head-up tilt test, and detection of 24-hour urinary sodium excretion, flow-mediated vasodilation, erythrocytic H2S, and plasma pro-adrenomedullin as biological markers were the new ways that were inexpensive, non-invasive, and easy to test for finding those who would be suitable for a specific drug and treatment. Conclusion: With the help of biomarkers, the therapeutic efficacy was greatly increased for children with postural tachycardia syndrome and vasovagal syncope.

Association of serotonin levels in patients of vasovagal syncope and postural tachycardia syndrome

2021 ◽  
pp. 1-10
Author(s):  
Hammad Raziq ◽  
Humaira Fayyaz ◽  
Rabia Azhar ◽  
Azmat Hayyat ◽  
Sobia Waqas
Keyword(s):  
Vasovagal Syncope ◽  
Test Method ◽  
Tilt Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Postural Tachycardia Syndrome ◽  
Postural Tachycardia ◽  
Group A ◽  
Head Up Tilt ◽  
Head Up Tilt Test ◽  
Group B

Abstract Objective: To determine the level of serotonin in patients of vasovagal syncope and postural tachycardia syndrome after head-up tilt test. Method: The cross-sectional analytical study was conducted at the Islamic International Medical College and the Department of Electrophysiology, Armed Forces Institute of Cardiology, Rawalpindi, from April 2017 to March 2018. Group A comprised cases of vasovagal syncope, group B had patients of postural tachycardia syndrome, and group C had healthy controls. Cases were chosen on the basis of history, episodes of syncope and findings of head-up tilt test. After the test, blood samples were taken for hormonal analysis of serotonin using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Results: Of the 80 subjects, 35(43.8%) were in group A, 35(43.8%) in group B and 10(12.4%) in group C. Mean serotonin value in group A was 918.39±380.16nM, in group B it was 1188.70±449.55nM., while in control group C the mean value was 771.40±376.14nM (p<0.05)  Conclusion: Serotonin was found to have a significant role in syncope pathophysiology. Continuous...

Symptom Score: A New Instrument to Assess Orthostatic Intolerance in Children and Adolescents

2020 ◽  
Vol 35 (12) ◽  
pp. 835-843
Author(s):  
Hong Cai ◽  
Shuo Wang ◽  
Runmei Zou ◽  
Ping Liu ◽  
Hong Yang ◽  
...  
Keyword(s):  
Symptom Score ◽  
Orthostatic Intolerance ◽  
Vasovagal Syncope ◽  
Tilt Test ◽  
Postural Tachycardia Syndrome ◽  
Median Score ◽  
Postural Tachycardia ◽  
New Instrument ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Objective: To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses. Methods: 272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups. Results: We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min ( P < .01). Conclusions: This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.

ASSESSMENT OF CORRELATION BETWEEN LEUKODERMA AND PSYCHIATRIC ILLNESS

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Mukesh Batra
Keyword(s):  
Psychiatric Illness ◽  
Study Participant ◽  
Simple Random Sampling ◽  
Anxiety Symptoms ◽  
Control Group ◽  
P Value ◽  
Common Symptom ◽  
Cross Sectional ◽  
Duration Of Disease ◽  
Illness Anxiety

Background: Leukoderma is an acquired disease of pigmentation which is presented by depigmented areas of different shape and sizes on the skin. In various researches it was reported that these defects in melanocytes occurred due to autoimmune pathway or the complex causation of oxidative stress and genetics. Material & Methods: In the present cross‑sectional prospective study 100 patients who were diagnosed with Leukoderma and controls who were not having depigmentation of skin and without any known clinical disease were enrolled for present study by simple random sampling. Written informed consent was taken from each study participant. Clearance from institutional ethical committee was also taken prior to the study. Results: The prevalence of psychiatric illness among leukoderma group was 22% and among 78% patients we did not found any psychiatric illness. The most common symptom was depression which was present among 22% of patients with Leukoderma and 18% patients with Leukoderma had anxiety symptoms. Among the control group depression was present in 5 % subjects and anxiety symptoms were present in 7% of subjects. The mean WHO-Quality of life scores was low among Leukoderma group in relation to the control group (p value <0.05). On correlation with psychiatric illness, observations were statistically non-significant (p > 0.05) with HAMA-A and HAMA- D. The observations were statistically significant (p < 0.05) with GHQ total and BSA score. Conclusion:  Higher prevalence of psychitric morbidity among patients with leukoderma and it was found associated with duration of disease and BSA scores. The most common symptom was depression which was followed by anxiety symptoms. Key words: Leukoderma, psychiatric illness, anxiety, depression.

scholarly journals The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey

2019 ◽  
Vol 286 (4) ◽  
pp. 438-448 ◽  
Author(s):  
B. H. Shaw ◽  
L. E. Stiles ◽  
K. Bourne ◽  
E. A. Green ◽  
C. A. Shibao ◽  
...  
Keyword(s):  
Online Community ◽  
Postural Tachycardia Syndrome ◽  
Community Based ◽  
Cross Sectional ◽  
Postural Tachycardia ◽  
The Face

Sex differences in the diagnosis of postural tachycardia syndrome: insights from a cross-sectional community based survey

2021 ◽  
Vol 37 (2) ◽  
pp. e17-e18
Author(s):  
K. Bourne ◽  
L. Stiles ◽  
R. Sheldon ◽  
C. Shibao ◽  
L. Okamoto ◽  
...  
Keyword(s):  
Sex Differences ◽  
Postural Tachycardia Syndrome ◽  
Community Based ◽  
Cross Sectional ◽  
Postural Tachycardia

scholarly journals Increased plasma angiotensin II in postural tachycardia syndrome (POTS) is related to reduced blood flow and blood volume

2006 ◽  
Vol 110 (2) ◽  
pp. 255-263 ◽  
Author(s):  
Julian M. Stewart ◽  
June L. Glover ◽  
Marvin S. Medow
Keyword(s):  
Blood Flow ◽  
Angiotensin Ii ◽  
Blood Volume ◽  
High Flow ◽  
The Other ◽  
Low Flow ◽  
Postural Tachycardia Syndrome ◽  
Peripheral Blood Flow ◽  
Ang Ii ◽  
Postural Tachycardia

POTS (postural tachycardia syndrome) is associated with low blood volume and reduced renin and aldosterone; however, the role of Ang (angiotensin) II has not been investigated. Previous studies have suggested that a subset of POTS patients with increased vasoconstriction related to decreased bioavailable NO (nitric oxide) have decreased blood volume. Ang II reduces bioavailable NO and is integral to the renin–Ang system. Thus, in the present study, we investigated the relationship between blood volume, Ang II, renin, aldosterone and peripheral blood flow in POTS patients. POTS was diagnosed by 70° upright tilt, and supine calf blood flow, measured by venous occlusion plethysmography, was used to subgroup POTS patients. A total of 23 POTS patients were partitioned; ten with low blood flow, eight with normal flow and five with high flow. There were ten healthy volunteers. Blood volume was measured by dye dilution. All biochemical measurements were performed whilst supine. Blood volume was decreased in low-flow POTS (2.14±0.12 litres/m2) compared with controls (2.76±0.20 litres/m2), but not in the other subgroups. PRA (plasma renin activity) was decreased in low-flow POTS compared with controls (0.49±0.12 compared with 0.90±0.18 ng of Ang I·ml−1·h−1 respectively), whereas plasma Ang II was increased (89±20 compared with 32±4 ng/l), but not in the other subgroups. PRA correlated with aldosterone (r=+0.71) in all subjects. PRA correlated negatively with blood volume (r=−0.72) in normal- and high-flow POTS, but positively (r=+0.65) in low-flow POTS. PRA correlated positively with Ang II (r=+0.76) in normal- and high-flow POTS, but negatively (r=−0.83) in low-flow POTS. Blood volume was negatively correlated with Ang II (r=−0.66) in normal- and high-flow POTS and in five low-flow POTS patients. The remaining five low-flow POTS patients had reduced blood volume and increased Ang II which was not correlated with blood volume. The data suggest that plasma Ang II is increased in low-flow POTS patients with hypovolaemia, which may contribute to local blood flow dysregulation and reduced NO bioavailability.

scholarly journals Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Fatma Al Hoqani ◽  
Wadha Al Ghafri ◽  
Saneya El tayeb ◽  
Yahya Al Farsi ◽  
Vaidyanathan Gowri
Keyword(s):  
Recurrent Miscarriage ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Recurrent Miscarriages ◽  
Sultan Qaboos University ◽  
Chi Squared ◽  
History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

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