Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome

Vera Novak, Peter Novak, Tonette L. Opfer-Gehrking, Peter C. O'Brien, Phillip Anson Low

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: To identify clinical and laboratory indices that improve the diagnosis of the postural tachycardia syndrome (POTS). Design: We assessed associations of orthostatic intolerance by using multivariate regression analysis. Material and Methods: We evaluated autonomic symptoms and autonomic function in 30 patients with POTS, 30 patients with mild orthostatic intolerance, and 19 age- and gender-matched control subjects. Indices of parasympathetic and sympathetic functions were analyzed on the basis of (1) autonomic function tests (head-up tilt), (2) oscillations at respiratory and nonrespiratory frequencies (0.01 to 0.09 Hz) in R-R interval and blood pressure (Wigner distribution), and (3) deterministic component (rescaled range analysis). Results: The four clinical and laboratory indices that independently supported the diagnosis of POTS are as follows: (1) orthostatic heart rate during the first minute of head-up tilt, (2) autonomic deficit (adrenergic autonomic score), (3) loss of spectral powers in R-R interval during head-up tilt at the fifth minute, and (4) severity of orthostatic dizziness, fatigue, palpitations, and shortness of breath. Conclusion: Enhancing the sensitivity and specificity of the diagnosis of POTS should be possible by using these four indices. A hyperadrenergic state and distal neuropathy, affecting adrenergic sympathetic cardiovagal fibers, seem to be involved in the pathophysiology of POTS. Certain features suggest brain-stem dysregulation.

Original languageEnglish (US)
Pages (from-to)1141-1150
Number of pages10
JournalMayo Clinic Proceedings
Volume73
Issue number12
StatePublished - 1998

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Postural Orthostatic Tachycardia Syndrome
Orthostatic Intolerance
Head
Adrenergic Agents
Adrenergic Fibers
Dizziness
Dyspnea
Brain Stem
Fatigue
Multivariate Analysis
Heart Rate
Regression Analysis
Blood Pressure
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Novak, V., Novak, P., Opfer-Gehrking, T. L., O'Brien, P. C., & Low, P. A. (1998). Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome. Mayo Clinic Proceedings, 73(12), 1141-1150.

Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome. / Novak, Vera; Novak, Peter; Opfer-Gehrking, Tonette L.; O'Brien, Peter C.; Low, Phillip Anson.

In: Mayo Clinic Proceedings, Vol. 73, No. 12, 1998, p. 1141-1150.

Research output: Contribution to journalArticle

Novak, V, Novak, P, Opfer-Gehrking, TL, O'Brien, PC & Low, PA 1998, 'Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome', Mayo Clinic Proceedings, vol. 73, no. 12, pp. 1141-1150.
Novak, Vera ; Novak, Peter ; Opfer-Gehrking, Tonette L. ; O'Brien, Peter C. ; Low, Phillip Anson. / Clinical and laboratory indices that enhance the diagnosis of postural tachycardia syndrome. In: Mayo Clinic Proceedings. 1998 ; Vol. 73, No. 12. pp. 1141-1150.
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