TY - JOUR
T1 - A prospective, 1-year follow-up study of postural tachycardia syndrome
AU - Kimpinski, Kurt
AU - Figueroa, Juan J.
AU - Singer, Wolfgang
AU - Sletten, David M.
AU - Iodice, Valeria
AU - Sandroni, Paola
AU - Fischer, Philip R.
AU - Opfer-Gehrking, Tonette L.
AU - Gehrking, Jade A.
AU - Low, Phillip A.
N1 - Funding Information:
Grant Support: This work was supported in part by National Institutes of Health ( NS 32352 Autonomic Disorders Program Project, NS 44233 Pathogenesis and Diagnosis of Multiple System Atrophy, U54 NS065736 Autonomic Rare Disease Clinical Consortium), Mayo CTSA ( UL1 RR24150 ), and Mayo Funds. The Autonomic Diseases Consortium is a part of the National Institutes of Health Rare Diseases Clinical Research Network (RDCRN). Funding and/or programmatic support for this project has been provided by U54 NS065736 from the National Institute of Neurological Diseases and Stroke and the National Institutes of Health Office of Rare Diseases Research .
PY - 2012/8
Y1 - 2012/8
N2 - 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.
AB - 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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U2 - 10.1016/j.mayocp.2012.02.020
DO - 10.1016/j.mayocp.2012.02.020
M3 - Article
C2 - 22795533
AN - SCOPUS:84866431940
SN - 0025-6196
VL - 87
SP - 746
EP - 752
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 8
ER -