Evidence map›Paper›PMID 34144933›Full record

ArticleAutonomic neuroscience : basic & clinical2021

Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1.

Steven Vernino, Kate M Bourne, Lauren E Stiles, Blair P Grubb, Artur Fedorowski, Julian M Stewart, Amy C Arnold, Laura A Pace, Jonas Axelsson, Jeffrey R Boris and 20 more

Registry-linked trialOpen access · bronzeAbstract readConsensus Development Conference, NIH
PubMed Full text at PMC Publisher
In one paragraph

Article in Autonomic neuroscience : basic & clinical, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06953661 (Ultrasound Guided Stellate Ganglion Block in Postural Tachycardia Syndrome), which is not on this map. Cited by 166 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 2 pooled it
36.4field-weighted citation impact, top 1% 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.

NCT06953661 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Ultrasound Guided Stellate Ganglion Block in Postural Tachycardia Syndrome: A Randomized Double Blind Sham Placebo-controlled Pilot Study

TypeinterventionalSponsorStanford UniversityRan2025 to 2026Enrolled20ConditionsPostural Tachycardia SyndromeArmsStellate ganglion block, Sham injection of saline, Ropivacaine, Normal saline
3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 2 syntheses or guidelines pooled it, 264 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Trial
  4. Trial
  5. Article
  6. Association between symptoms of pediatric postural orthostatic tachycardia syndrome and joint hypermobility syndromes.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Observational
  17. Article
  18. Article
  19. Utilization of machine learning in diagnosis of postural tachycardia syndrome (POTS).Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  20. Letter to the Editor.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article

106 more citing papers are in PubMed but not listed here.

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

30 authors at 20 institutions in 3 countries.

Steven VerninoDepartment of Neurology, UT Southwestern Medical Center, Dallas, TX, USA.
Kate M BourneDepartment of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Lauren E StilesDepartment of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA; Dysautonomia International, East Moriches, NY, USA.
Blair P GrubbDivision of Cardiology, Department of Medicine, The University of Toledo Medical Center, USA.
Artur FedorowskiDepartment of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.
Julian M StewartCenter for Hypotension, Departments of Pediatrics and Physiology, New York Medical College, Valhalla, NY, USA.
Amy C ArnoldDepartment of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA; Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Laura A PaceCenter for Genomic Medicine and Department of Pediatrics, Division of Medical Genetics and Genomics, University of Utah, Salt Lake City, UT, USA.
Jonas AxelssonDepartment of Clinical Immunology, Karolinska University Hospital, Stockholm, Sweden.
Jeffrey R BorisJeffrey R Boris MD LLC, Moylan, PA, USA.
Jeffrey P MoakDepartment of Pediatrics, George Washington Univeristy School of Medicine and Health Sciences, Washington, DC, USA.
Brent P GoodmanNeuromuscular Division, Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
Kamal R ChémaliDepartment of Neurology, Eastern Virginia Medical School, Division of Neurology, Neuromuscular and Autonomic Center, Sentara Healthcare, Norfolk, VA, USA.
Tae H ChungDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
David S GoldsteinAutonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Andre DiedrichAutonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine and Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN, USA.
Mitchell G MiglisDepartment of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
Melissa M CortezDepartment of Neurology, University of Utah, Salt Lake City, UT, USA.
Amanda J MillerDepartment of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Roy FreemanDepartment of Neurology, Harvard Medical School, Boston, MA, USA; Center for Autonomic and Peripheral Nerve Disorders, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Italo BiaggioniAutonomic Dysfunction Center, Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA.
Peter C RoweDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Robert S SheldonDepartment of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Cyndya A ShibaoAutonomic Dysfunction Center, Division of Clinical Pharmacology, Departments of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
David M SystromPulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Glen A CookDepartment of Neurology, Uniformed Services University, Bethesda, MD, USA.
Taylor A DohertyDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
Hasan I AbdallahChildren's Heart Institute, Fredericksburg, VA, USA.
Anil DarbariPediatric Gastroenterology, Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Satish R RajDepartment of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: satish.raj@ucalgary.ca.
Vanderbilt University Medical Center · USGeorge Washington University · USHarvard University · USJohns Hopkins University · USLibin Cardiovascular Institute of Alberta · CAPennsylvania State University · USUniversity of Utah · USEastern Virginia Medical School · USKarolinska University Hospital · SEMayo Clinic in Arizona · USNational Institutes of Health · USNew York Medical College · USSkåne University Hospital · SESouthwestern Medical Center · USStanford University · USStony Brook School · USUniformed Services University of the Health Sciences · USUniversity of Calgary · CAUniversity of California, San Diego · USUniversity of Toledo Medical Center · US

Funding

Structural genomics of norepinephrine transportersP01HL056693 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BIAGGIONI, ITALO · 1997 to 2016
$30.8M
Biomarkers of Parkinson Disease and Related DisordersZIANS003034 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI GOLDSTEIN, DAVID · 2009 to 2025
$22.8M
Cardiovagal baroreflex deficits impair neurovascular coupling and cognition in Postural Tachycardia SyndromeR01HL134674 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2017 to 2020
$2.5M
Autonomic Determinants of Postural Tachycardia SyndromeR01HL142583 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 2019 to 2022
$1.7M
Alteration of kynurenine pathway in age-associated muscle weaknessK08AG058483 · NIA · JOHNS HOPKINS UNIVERSITY · PI CHUNG, TAE HWAN · 2018 to 2022
$854k
Autonomic Determinants of Postural Tachycardia SyndromeR56HL142583 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 2018 to 2018
$391k
Neurocardiology: Catecholamine Systems In Stress and DisZ01NS002979 · NINDS · NEUROLOGICAL DISORDERS AND STROKE · PI GOLDSTEIN, DAVID S · 1999 to 2006
–
Intramural NIH HHS Z01 NS002979NHLBI NIH HHS P01 HL056693NHLBI NIH HHS R01 HL134674NHLBI NIH HHS R01 HL142583NHLBI NIH HHS R56 HL142583NIA NIH HHS K08 AG058483
6 · The paper itself

Abstract

Postural orthostatic tachycardia syndrome (POTS) is a chronic and often disabling disorder characterized by orthostatic intolerance with excessive heart rate increase without hypotension during upright posture. Patients often experience a constellation of other typical symptoms including fatigue, exercise intolerance and gastrointestinal distress. A typical patient with POTS is a female of child-bearing age, who often first displays symptoms in adolescence. The onset of POTS may be precipitated by immunological stressors such as a viral infection. A variety of pathophysiologies are involved in the abnormal postural tachycardia response; however, the pathophysiology of the syndrome is incompletely understood and undoubtedly multifaceted. Clinicians and researchers focused on POTS convened at the National Institutes of Health in July 2019 to discuss the current state of understanding of the pathophysiology of POTS and to identify priorities for POTS research. This article, the first of two articles summarizing the information discussed at this meeting, summarizes the current understanding of this disorder and best practices for clinical care. The evaluation of a patient with suspected POTS should seek to establish the diagnosis, identify co-morbid conditions, and exclude conditions that could cause or mimic the syndrome. Once diagnosed, management typically begins with patient education and non-pharmacologic treatment options. Various medications are often used to address specific symptoms, but there are currently no FDA-approved medications for the treatment of POTS, and evidence for many of the medications used to treat POTS is not robust.

Indexed as

Orthostatic IntolerancePostural Orthostatic Tachycardia SyndromeAdolescentConsensusFemaleHeart RateHumansNational Institutes of Health (U.S.)United StatesExpert consensusPathophysiologyPostural orthostatic tachycardia syndromeTreatmentWorkshop

Identifiers

PMID34144933
PMCPMC8455420
OpenAlexW3170339939

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.