Deconditioning in patients with orthostatic intolerance

Ajay Parsaik, Thomas G. Allison, Wolfgang Singer, David M. Sletten, Michael Joseph Joyner, Eduardo E. Benarroch, Phillip Anson Low, Paola Sandroni

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: To study the frequency and degree of deconditioning, clinical features, and relationship between deconditioning and autonomic parameters in patients with orthostatic intolerance. Methods: We retrospectively studied all patients seen for orthostatic intolerance at Mayo Clinic between January 2006 and June 2011, who underwent both standardized autonomic and exercise testing. Results: A total of 184 patients (84 with postural orthostatic tachycardia syndrome [POTS] and 100 without orthostatic tachycardia) fulfilled the inclusion criteria. Of these, 89% were women, and median age was 27.5 years (interquartile range [IQR] 22-37 years). Symptom duration was 4 years (IQR 2-7.8). Of the patients, 90% had deconditioning (reduced maximum oxygen uptake [VO2max%] <85%) during exercise. This finding was unrelated to age, gender, or duration of illness. The prevalence of deconditioning was similar between those with POTS (95%) and those with orthostatic intolerance (91%). VO2max% had a weak correlation with a few autonomic and laboratory parameters but adequate predictors of VO2max%could not be identified. Conclusion: Reduced VO2max% consistent with deconditioning is present in almost all patients with orthostatic intolerance and may play a central role in pathophysiology. This finding provides a strong rationale for retraining in the treatment of orthostatic intolerance. None of the autonomic indices are reliable predictors of deconditioning.

Original languageEnglish (US)
Pages (from-to)1435-1439
Number of pages5
JournalNeurology
Volume79
Issue number14
DOIs
StatePublished - Oct 2 2012

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Orthostatic Intolerance
Postural Orthostatic Tachycardia Syndrome
Exercise
Tachycardia
Intolerance
Oxygen

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Parsaik, A., Allison, T. G., Singer, W., Sletten, D. M., Joyner, M. J., Benarroch, E. E., ... Sandroni, P. (2012). Deconditioning in patients with orthostatic intolerance. Neurology, 79(14), 1435-1439. https://doi.org/10.1212/WNL.0b013e31826d5f95

Deconditioning in patients with orthostatic intolerance. / Parsaik, Ajay; Allison, Thomas G.; Singer, Wolfgang; Sletten, David M.; Joyner, Michael Joseph; Benarroch, Eduardo E.; Low, Phillip Anson; Sandroni, Paola.

In: Neurology, Vol. 79, No. 14, 02.10.2012, p. 1435-1439.

Research output: Contribution to journalArticle

Parsaik, A, Allison, TG, Singer, W, Sletten, DM, Joyner, MJ, Benarroch, EE, Low, PA & Sandroni, P 2012, 'Deconditioning in patients with orthostatic intolerance', Neurology, vol. 79, no. 14, pp. 1435-1439. https://doi.org/10.1212/WNL.0b013e31826d5f95
Parsaik A, Allison TG, Singer W, Sletten DM, Joyner MJ, Benarroch EE et al. Deconditioning in patients with orthostatic intolerance. Neurology. 2012 Oct 2;79(14):1435-1439. https://doi.org/10.1212/WNL.0b013e31826d5f95
Parsaik, Ajay ; Allison, Thomas G. ; Singer, Wolfgang ; Sletten, David M. ; Joyner, Michael Joseph ; Benarroch, Eduardo E. ; Low, Phillip Anson ; Sandroni, Paola. / Deconditioning in patients with orthostatic intolerance. In: Neurology. 2012 ; Vol. 79, No. 14. pp. 1435-1439.
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