Evidence map›Paper›PMID 25792354›Full record

Trial reportCirculation. Arrhythmia and electrophysiology2015

Inspiratory resistance improves postural tachycardia: a randomized study.

Alfredo Gamboa, Sachin Y Paranjape, Bonnie K Black, Amy C Arnold, Rocío Figueroa, Luis E Okamoto, Victor C Nwazue, Andre Diedrich, W Dale Plummer, William D Dupont and 2 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Arrhythmia and electrophysiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00962728 (Assessment of Inspiratory Breathing Devices to Improve Orthostatic Tolerance in Postural Orthostatic Tachycardia Syndrome), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00962728 naactive not recruitingnot on this map

Assessment of Inspiratory Breathing Devices to Improve Orthostatic Tolerance in Postural Orthostatic Tachycardia Syndrome

TypeinterventionalSponsorAlfredo GamboaRan2009 to 2026Enrolled30ConditionsPostural Tachycardia Syndrome, Postural Orthostatic Tachycardia SyndromeArmsInspiratory Threshold Device (Res-Q-Gard ITD), Sham Inspiratory Threshold Device
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Systematic literature review: treatment of postural orthostatic tachycardia syndrome (POTS).Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Pooled it
  2. Exercise and non-pharmacological treatment of POTS.Autonomic neuroscience : basic & clinical · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 2 countries.

Alfredo GamboaFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.). alfredo.gamboa@vanderbilt.edu.
Sachin Y ParanjapeFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Bonnie K BlackFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Amy C ArnoldFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Rocío FigueroaFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Luis E OkamotoFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Victor C NwazueFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Andre DiedrichFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
W Dale PlummerFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
William D DupontFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
David RobertsonFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Satish R RajFrom the Division of Clinical Pharmacology (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Departments of Medicine (A.G., S.Y.P., B.K.B., A.C.A., R.F., L.E.O., V.C.N., A.D., D.R., S.R.R.), Pharmacology (D.R., S.R.R.), Biostatistics (W.D.P., W.D.D.), and Neurology (D.R.), Vanderbilt University, Nashville, TN; and Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (W.D.P., W.D.D.).
Anna Needs Neuroblastoma Answers · US

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Structural genomics of norepinephrine transportersP01HL056693 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 1997 to 2016
$30.8M
Training CoreU54NS065736 · NINDS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BIAGGIONI, ITALO · 2009 to 2018
$11.6M
CLINICAL AND TRANSLATIONAL SCIENCE COORDINATING CENTER: AIDSU54RR032646 · NCRR · VANDERBILT UNIVERSITY · PI BERNARD, GORDON RAPHAEL · 2011 to 2011
$3.8M
Aldosterone and Sodium Regulation in Postural Tachycardia SyndromeR01HL102387 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GARLAND, EMILY M · 2010 to 2014
$2.1M
Sympathetic Nervous System and Nitric Oxide in Obesity Associated HypertensionK23HL095905 · NHLBI · VANDERBILT UNIVERSITY · PI GAMBOA, ALFREDO · 2010 to 2014
$754k
NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1TR000445NCRR NIH HHS U54 RR032646NCRR NIH HHS U54RR032646NHLBI NIH HHS K23 HL095905NHLBI NIH HHS K23HL95905NHLBI NIH HHS P01 HL056693NHLBI NIH HHS P01HL056693NHLBI NIH HHS R01 HL102387NHLBI NIH HHS R01HL102387NINDS NIH HHS 5U54NS065736NINDS NIH HHS U54 NS065736
6 · The paper itself

Abstract

backgroundThe objective of this study was to determine the effect of inspiratory resistance through an impedance threshold device (ITD) on orthostatic tolerance in patients with postural tachycardia syndrome. We hypothesized that the ITD would result in a greater negative intrathoracic pressure to enhance cardiac venous return, improve stroke volume, and reduce heart rate in these patients. METHODS AND

resultsWe compared the effect of a sham device (sham, no resistance) versus an ITD (increased inspiratory resistance) in 26 patients with postural tachycardia syndrome in a randomized, single-blind, crossover study. Hemodynamic assessments were performed at baseline while supine and during head-up tilt to 70° for 10 minutes. We did not find differences in baseline hemodynamic parameters between the ITD and the sham devices. After 10 minutes of head-up tilt, the heart rate was lower with the ITD versus sham device (102±4 versus 109±4 beat/min, respectively; P=0.003). The ITD also improved stroke volume compared with the sham device (35±2 versus 26±1 mL; P=0.006).

conclusionsThese findings suggest that increasing negative intrathoracic pressure with ITD breathing improves heart rate control in patients with postural tachycardia syndrome during upright posture. CLINICAL

trial registrationclinicaltrials.gov; Unique Identifier: NCT00962728.

Indexed as

Airway ResistanceInhalationAdultCross-Over StudiesEquipment DesignFemaleHeart RateHumansMalePatient PositioningPostural Orthostatic Tachycardia SyndromePressureSingle-Blind MethodStroke VolumeSuctionSupine Positionautonomic nervous systempostural tachycardia syndromestroke volumetachycardia

Identifiers

PMID25792354
PMCPMC4472504
OpenAlexW2335536066

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.