Evidence map›Paper›PMID 34246578›Full record

ArticleAutonomic neuroscience : basic & clinical2021

Postural orthostatic tachycardia syndrome (POTS): Priorities for POTS care and research from a 2019 National Institutes of Health Expert Consensus Meeting - Part 2.

Satish R Raj, Kate M Bourne, Lauren E Stiles, Mitchell G Miglis, Melissa M Cortez, Amanda J Miller, Roy Freeman, Italo Biaggioni, Peter C Rowe, Robert S Sheldon and 20 more

2 registry-linked trialsOpen access · hybridAbstract readConsensus Development Conference, NIH
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 2 registered trials, which are not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
8.8field-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.

NCT06292104 recruitingnot on this mapstarted 2024, after this paper: background citation

Multimodality Deep Phenotyping of Postural Orthostatic Tachycardia Syndrome (POTS), Aim 1

Typeobservational_patient_registrySponsorUniversity of Texas Southwestern Medical CenterRan2024 to 2029Enrolled350ConditionsPostural Orthostatic Tachycardia SyndromeArmsmultimodal diagnostic testing
NCT07579026 narecruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Breathing Retraining Exercises on Heartrate, Blood Pressure and Orthostatic Intolerance in Pregnant Females With Postural Orthostatic Tachycardia Syndrome.

TypeinterventionalSponsorRiphah International UniversityRan2025 to 2026Enrolled44ConditionsOrthostatic Hypotension, Heart Rate, Blood PressureArmsdiaphragmatic breathing exercise, educational retraining
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.

  1. Pooled it
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  3. Diagnostic strategies, test accuracy, and misdiagnosis of POTS: a narrative review of diagnostic criteria, tests, and diagnostic delay.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Review
  4. Hemodynamic and cerebral oxygenation predictors of visual darkening in pediatric POTS: a cross-sectional study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
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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.

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.
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.
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, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of 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, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Andre DiedrichAutonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine and Biomedical Engineering, 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.
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 ArnoldAutonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, PA, 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 University 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.
Anil DarbariDepartment of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Steven VerninoDepartment of Neurology, UT Southwestern Medical Center, Dallas, TX, USA.
Vanderbilt University Medical Center · USGeorge Washington University · USPennsylvania State University · USUniversity of Calgary · CAUniversity of Utah · USBeth Israel Deaconess Medical Center · USEastern Virginia Medical School · USHarvard University · USJohns Hopkins Medicine · USJohns Hopkins University · USKarolinska University Hospital · SELibin Cardiovascular Institute of Alberta · CALund University · SEMayo Clinic in Arizona · USNational Institutes of Health · USNew York Medical College · USStanford University · USStony Brook School · USThe University of Texas Southwestern Medical Center · USUniformed Services University of the Health Sciences · US

Funding

Structural genomics of norepinephrine transportersP01HL056693 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 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
Sympathetic Mechanisms in the Cardiovascular and Metabolic Alterations of ObesityR01HL149386 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BIAGGIONI, ITALO · 2019 to 2023
$3.0M
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
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 R01 HL149386NHLBI NIH HHS R56 HL142583
6 · The paper itself

Abstract

The National Institutes of Health hosted a workshop in 2019 to build consensus around the current state of understanding of the pathophysiology of postural orthostatic tachycardia syndrome (POTS) and to identify knowledge gaps that must be addressed to enhance clinical care of POTS patients through research. This second (of two) articles summarizes current knowledge gaps, and outlines the clinical and research priorities for POTS. POTS is a complex, multi-system, chronic disorder of the autonomic nervous system characterized by orthostatic intolerance and orthostatic tachycardia without hypotension. Patients often experience a host of other related disabling symptoms. The functional and economic impacts of this disorder are significant. The pathophysiology remains incompletely understood. Beyond the significant gaps in understanding the disorder itself, there is a paucity of evidence to guide treatment which can contribute to suboptimal care for this patient population. The vast majority of physicians have minimal to no familiarity or training in the assessment and management of POTS. Funding for POTS research remains very low relative to the size of the patient population and impact of the syndrome. In addition to efforts to improve awareness and physician education, an investment in research infrastructure including the development of standardized disease-specific evaluation tools and outcome measures is needed to facilitate effective collaborative research. A national POTS research consortium could facilitate well-controlled multidisciplinary clinical research studies and therapeutic trials. These priorities will require a substantial increase in the number of research investigators and the amount of research funding in this area.

Indexed as

Orthostatic IntolerancePostural Orthostatic Tachycardia SyndromeAutonomic Nervous SystemConsensusHumansNational Institutes of Health (U.S.)United StatesExpert ConsensusPathophysiologyPostural orthostatic tachycardia syndromeTreatmentWorkshop

Identifiers

PMID34246578
PMCPMC8455430
OpenAlexW3176692819

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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.