A prospective, 1-year follow-up study of postural tachycardia syndrome. Mayo Clin Proc 2012 Aug;87(8):746-52
Date
07/17/2012Pubmed ID
22795533Pubmed Central ID
PMC3538485DOI
10.1016/j.mayocp.2012.02.020Scopus ID
2-s2.0-84866431940 (requires institutional sign-in at Scopus site) 67 CitationsAbstract
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.
Author List
Kimpinski K, Figueroa JJ, Singer W, Sletten DM, Iodice V, Sandroni P, Fischer PR, Opfer-Gehrking TL, Gehrking JA, Low PAAuthor
Juan Jose Figueroa MD Assistant Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adrenergic alpha-1 Receptor AgonistsAdrenergic beta-1 Receptor Antagonists
Adult
Anti-Inflammatory Agents
Atenolol
Cholinesterase Inhibitors
Female
Fludrocortisone
Follow-Up Studies
Heart Rate
Humans
Male
Metoprolol
Midodrine
Nadolol
Norepinephrine
Postural Orthostatic Tachycardia Syndrome
Propranolol
Prospective Studies
Pyridostigmine Bromide
Severity of Illness Index
Sodium
Tilt-Table Test
Virus Diseases
