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Syndromes of orthostatic intolerance and syncope in young adults.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- Current Landscape of Compression Products for Treatment of Postural Orthostatic Tachycardia Syndrome and Neurogenic Orthostatic Hypotension.Journal of clinical medicine · 2024Article
- Clinical and endocrine features of orthostatic intolerance detected in patients with long COVID.Scientific reports · 2024Article
- Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID.Journal of personalized medicine · 2024Article
- Symptom presentation by phenotype of postural orthostatic tachycardia syndrome.Scientific reports · 2024Article
- Malmö POTS symptom score: Assessing symptom burden in postural orthostatic tachycardia syndrome.Journal of internal medicine · 2023Article
- Posture-Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi.Journal of the American Heart Association · 2022Article
- Spectrum of underlying diseases in syncope and treatment of neurally-mediated syncope in children and adolescents over the past 30 years: A single center study.Frontiers in cardiovascular medicine · 2022Article
- Management of orthostatic intolerance in children: the state of the art.World journal of pediatrics : WJP · 2020Article
- Prevalence and factors related to orthostatic syndromes in recently diagnosed, drug-naïve patients with Parkinson disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2020Article
- Proteomic analysis reveals sex-specific biomarker signature in postural orthostatic tachycardia syndrome.BMC cardiovascular disorders · 2020Article
- Twenty-four-hour urine NE level as a predictor of the therapeutic response to metoprolol in children with recurrent vasovagal syncope.Irish journal of medical science · 2019Article
- The face of postural tachycardia syndrome - insights from a large cross-sectional online community-based survey.Journal of internal medicine · 2019Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore the clinical and neuroendocrine characteristics of syndromes of orthostatic intolerance and syncope in young adults.
methodsTwo hundred and thirty-six patients aged 18-40 years with orthostatic intolerance and/or syncope were examined by head-up tilt test (HUT). Plasma levels of epinephrine, norepinephrine, renin, C-terminal-pro-arginine-vasopressin (CT-proAVP), C-terminal-endothelin-1 and mid-regional-fragment of pro-atrial-natriuretic-peptide (MR-proANP) were analysed. Patients' history, haemodynamic parameters and plasma biomarkers were related to main diagnoses such as vasovagal syncope (VVS), postural tachycardia syndrome (POTS), orthostatic hypotension (OH) and negative HUT.
resultsNo self-reported symptom of orthostatic intolerance was highly specific for any diagnosis. Patients with VVS (n=103) were more likely to be men (p=0.011) and had lower resting heart rate (HR; 66±11) compared with POTS (73±11; n=72; p=0.001) and negative HUT (74±11; n=39; p=0.001). Patients with POTS demonstrated greater rise in norepinephrine (p=0.008) and CT-proAVP (p=0.033) on standing compared with negative HUT, and lower resting MR-proANP compared with VVS (p=0.04) and OH (p=0.03). Patients with OH had lower resting renin (p=0.03). Subjects with a resting HR <70 and MR-proANP >45 pm/L had an OR of 3.99 (95 % CI 1.68 to 9.52; p=0.002) for VVS compared with subjects without any of these criteria; if male sex was added the OR was 21.8 (95% CI 3.99 to 119; p<0.001).
conclusionsSyndromes of orthostatic intolerance and syncope share many characteristics in younger persons. However, patients with VVS are more likely to be men, have lower HR and higher MR-proANP at rest compared with POTS, which might be taken into account at an early stage of evaluation.
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