A prospective, 1-year follow-up study of postural tachycardia syndrome

Kurt Kimpinski, Juan J. Figueroa, Wolfgang Singer, David M. Sletten, Valeria Iodice, Paola Sandroni, Philip R. Fischer, Tonette L. Opfer-Gehrking, Jade A. Gehrking, Phillip Anson Low

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results: Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8=15.1 beats/min) compared with baseline (37.8=14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year. Conclusion: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.

Original languageEnglish (US)
Pages (from-to)746-752
Number of pages7
JournalMayo Clinic Proceedings
Volume87
Issue number8
DOIs
StatePublished - Aug 2012

Fingerprint

Postural Orthostatic Tachycardia Syndrome
Heart Rate
Head
Virus Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A prospective, 1-year follow-up study of postural tachycardia syndrome. / Kimpinski, Kurt; Figueroa, Juan J.; Singer, Wolfgang; Sletten, David M.; Iodice, Valeria; Sandroni, Paola; Fischer, Philip R.; Opfer-Gehrking, Tonette L.; Gehrking, Jade A.; Low, Phillip Anson.

In: Mayo Clinic Proceedings, Vol. 87, No. 8, 08.2012, p. 746-752.

Research output: Contribution to journalArticle

Kimpinski, K, Figueroa, JJ, Singer, W, Sletten, DM, Iodice, V, Sandroni, P, Fischer, PR, Opfer-Gehrking, TL, Gehrking, JA & Low, PA 2012, 'A prospective, 1-year follow-up study of postural tachycardia syndrome', Mayo Clinic Proceedings, vol. 87, no. 8, pp. 746-752. https://doi.org/10.1016/j.mayocp.2012.02.020
Kimpinski, Kurt ; Figueroa, Juan J. ; Singer, Wolfgang ; Sletten, David M. ; Iodice, Valeria ; Sandroni, Paola ; Fischer, Philip R. ; Opfer-Gehrking, Tonette L. ; Gehrking, Jade A. ; Low, Phillip Anson. / A prospective, 1-year follow-up study of postural tachycardia syndrome. In: Mayo Clinic Proceedings. 2012 ; Vol. 87, No. 8. pp. 746-752.
@article{2ae447e6817b46959f41be0a22340f2e,
title = "A prospective, 1-year follow-up study of postural tachycardia syndrome",
abstract = "Objective: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results: Patients were predominantly young females (n=49, 84{\%}), with 20 patients (34{\%}) reporting an antecedent viral infection before onset of symptoms. More than one-third (37{\%}) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8=15.1 beats/min) compared with baseline (37.8=14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95{\%}) at baseline and 48 patients (92{\%}) at 1 year. Conclusion: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.",
author = "Kurt Kimpinski and Figueroa, {Juan J.} and Wolfgang Singer and Sletten, {David M.} and Valeria Iodice and Paola Sandroni and Fischer, {Philip R.} and Opfer-Gehrking, {Tonette L.} and Gehrking, {Jade A.} and Low, {Phillip Anson}",
year = "2012",
month = "8",
doi = "10.1016/j.mayocp.2012.02.020",
language = "English (US)",
volume = "87",
pages = "746--752",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "8",

}

TY - JOUR

T1 - A prospective, 1-year follow-up study of postural tachycardia syndrome

AU - Kimpinski, Kurt

AU - Figueroa, Juan J.

AU - Singer, Wolfgang

AU - Sletten, David M.

AU - Iodice, Valeria

AU - Sandroni, Paola

AU - Fischer, Philip R.

AU - Opfer-Gehrking, Tonette L.

AU - Gehrking, Jade A.

AU - Low, Phillip Anson

PY - 2012/8

Y1 - 2012/8

N2 - Objective: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results: Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8=15.1 beats/min) compared with baseline (37.8=14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year. Conclusion: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.

AB - Objective: To prospectively evaluate patients who met standard criteria for postural tachycardia syndrome (POTS), at baseline and 1-year follow-up, using standard clinical and laboratory methods to assess autonomic function. Methods: Fifty-eight patients met the study criteria (orthostatic symptoms and a heart rate increment of≥30 beats/min on head-up tilt) and completed 12 months of follow-up. All patients were enrolled and completed the study from January 16, 2006, through April 15, 2009. Patients underwent standardized autonomic testing, including head-up tilt, clinical assessment, and validated questionnaires designed to determine the severity of autonomic symptoms. Results: Patients were predominantly young females (n=49, 84%), with 20 patients (34%) reporting an antecedent viral infection before onset of symptoms. More than one-third (37%) no longer fulfilled tilt criteria for POTS on follow-up, although heart rate increment on head-up tilt did not differ significantly at 1 year (33.8=15.1 beats/min) compared with baseline (37.8=14.6 beats/min) for the entire cohort. Orthostatic symptoms improved in most patients. Autonomic dysfunction was mild as defined by a Composite Autonomic Severity Score of 3 or less in 55 patients (95%) at baseline and 48 patients (92%) at 1 year. Conclusion: To our knowledge, this is the first prospective study of the clinical outcomes of patients with POTS. Orthostatic symptoms improved in our patients, with more than one-third of patients no longer fulfilling tilt criteria for POTS, although the overall group change in heart rate increment was modest. Our data are in keeping with a relatively favorable prognosis in most patients with POTS.

UR - http://www.scopus.com/inward/record.url?scp=84866431940&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866431940&partnerID=8YFLogxK

U2 - 10.1016/j.mayocp.2012.02.020

DO - 10.1016/j.mayocp.2012.02.020

M3 - Article

C2 - 22795533

AN - SCOPUS:84866431940

VL - 87

SP - 746

EP - 752

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 8

ER -