Evidence map›Paper›PMID 40537187›Full record

ArticleJACC. CardioOncology2025

Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation.

Georgia K Thomas, Josh West, Michele Golino, Emily Kontos, Emily Federmann, William Clark, John McCarty, Thomas Chelimsky, Benjamin VanTassell, Maria Toumpourleka and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Transcutaneous auricular vagus nerve stimulation improves dysautonomia in patients with hypermobile Ehlers-Danlos syndrome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  2. Article
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

13 authors.

Georgia K ThomasVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA. Electronic address: georgia.thomas@vcuhealth.org.
Josh WestVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Michele GolinoVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Emily KontosVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Emily FedermannVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
William ClarkDepartment of Radiation Oncology, VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA.
John McCartyDepartment of Radiation Oncology, VCU Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Thomas ChelimskyComprehensive Autonomic Center, VCU Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA.
Benjamin VanTassellVCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Maria ToumpourlekaCardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Pietro E LazzeriniElectroimmunology Unit, Division of Internal Medicine and Geriatrics, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Stavros StavrakisCardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Antonio AbbateBerne Cardiovascular Research Center and Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostural orthostatic tachycardia (POTS) and orthostatic hypotension (OH) commonly occur after hematopoietic stem cell transplantation (HSCT).

objectivesThis study sought to determine the prevalence of POTS and OH before HSCT and the incidence of new cases after HSCT.

methodsIn this single-center, prospective study, patients were evaluated 30 days before and 30 and 100 days after HSCT. Blood pressure, heart rate, and plasma norepinephrine levels were measured in the supine position and after a 10-minute active stand test to assess for POTS or OH. After HSCT, adrenergic receptor (AR)-modulating autoantibody activity was measured in 8 subjects with POTS and 8 without.

resultsAmong 46 patients, 40 (87.0%) underwent autologous and 6 (13.0%) allogeneic HSCT. Multiple myeloma was the most common indication (67.4%). Before HSCT, the prevalence of both POTS and OH was 4.3%. At 30 days after HSCT, POTS was present in 10 (25.6%) of 39 patients, including 9 (23.1%) new cases, and OH in 6 (15.4%), including 5 (12.8%) new cases. Patients with POTS at 30 days showed a significantly greater increase in norepinephrine levels upon standing (median 231% [Q1-Q3: 179%-343%]) compared with before HSCT (median 100% [Q1-Q3: 62%-183%]) (P = 0.005), which positively correlated with heart rate changes. AR-modulating autoantibody activity was also higher in patients with POTS vs those without and directly correlated with heart rate changes.

conclusionsApproximately 1 in 4 patients developed POTS after HSCT, characterized by exaggerated increases in norepinephrine upon standing and elevated AR-modulating autoantibody activity.

Indexed as

autonomic dysfunctionbone marrow transplantationcancer survivorshipdiagnosismechanismsorthostatic hypotensionpostural orthostatic tachycardiastem cell transplantation

Identifiers

PMID40537187
PMCPMC12228132

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.