Key result
POTS shows higher resting and early-tilt HR and cerebral blood flow velocity versus dizziness or syncope.
Why the study?
The cerebral blood flow velocity response during the first minute of head-up tilt in patients with POTS or neurally-mediated reflex syncope compared with patients with dizziness was not well characterized.
Does cerebral blood flow velocity differ during supine rest and the first minute of head-up tilt among patients with POTS, neurally-mediated reflex syncope, and dizziness?
Observational (n=120)
Does cerebral blood flow velocity differ during supine rest and the first minute of head-up tilt among patients with POTS, neurally-mediated reflex syncope, and dizziness?
p-value: p=<0.05
Patients with POTS exhibit higher baseline and tilt-induced cerebral blood flow velocity and heart rate compared to those with syncope or dizziness, suggesting an underlying autonomic dysfunction that is accentuated by upright posture.
POTS patients show higher supine and early-tilt CBF velocity than controls; leaves open diagnostic utility and requires prospective validation.
AIM: To assess the cerebral blood flow velocity during the first minute of head-up tilt in patients with postural tachycardia syndrome (POTS) or neurally-mediated reflex syncope compared with patients with dizziness. METHODS: We evaluated 120 patients selected from 470 patients who underwent head-up tilt testing: 40 with POTS, 40 with typical neurally-mediated reflex syncope and 40 who complained of dizziness with no history of loss of consciousness and a negative head-up tilt test (with and without isosorbide). Transcranial Doppler sonography of the middle cerebral artery, heart rate and brachial blood pressure were recorded during a 70 degrees head-up tilt test. RESULTS: During both baseline in supine position and the first minute of upright tilt, patients with postural tachycardia syndrome showed higher heart rate and cerebral blood flow velocity than patients with dizziness and patients with neurally-mediated reflex syncope (P < 0.05, ANOVA), but no significant difference was observed on the Gosling's pulsatility index. CONCLUSION: Patients with POTS have an autonomic dysfunction that is not triggered by upright posture but is accentuated by it.
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Jáuregui‐Renaud et al. (2005) conducted an observational in Orthostatic intolerance (n=120). Postural tachycardia syndrome (POTS) vs. Patients with dizziness and patients with neurally-mediated reflex syncope was evaluated on Cerebral blood flow velocity and heart rate (p=<0.05). Patients with postural tachycardia syndrome had higher heart rate and cerebral blood flow velocity during supine rest and early head-up tilt than those with dizziness or syncope (P<0.05).
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