Reduced stroke volume during exercise in postural tachycardia syndrome

Shizue Masuki, John H. Eisenach, William G. Schrage, Christopher P. Johnson, Niki M. Dietz, Brad W. Wilkins, Paola Sandroni, Phillip Anson Low, Michael Joseph Joyner

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Postural tachycardia syndrome (POTS) is characterized by excessive tachycardia without hypotension during orthostasis. Most POTS patients also report exercise intolerance. To assess cardiovascular regulation during exercise in POTS, patients (n = 13) and healthy controls (n = 10) performed graded cycle exercise at 25, 50, and 75 W in both supine and upright positions while arterial pressure (arterial catheter), heart rate (HR; measured by ECG), and cardiac output (open-circuit acetylene breathing) were measured. In both positions, mean arterial pressure, cardiac output, and total peripheral resistance at rest and during exercise were similar in patients and controls (P > 0.05). However, supine stroke volume (SV) tended to be lower in the patients than controls at rest (99 ± 5 vs. 110 ± 9 ml) and during 75-W exercise (97 ± 5 vs. 111 ± 7 ml) (P = 0.07), and HR was higher in the patients than controls at rest (76 ± 3 vs. 62 ± 4 beats/min) and during 75-W exercise (127 ± 3 vs. 114 ± 5 beats/min) (both P < 0.01). Upright SV was significantly lower in the patients than controls at rest (57 ± 3 vs. 81 ± 6 ml) and during 75-W exercise (70 ± 4 vs. 94 ± 6 ml) (both P < 0.01), and HR was much higher in the patients than controls at rest (103 ± 3 vs. 81 ± 4 beats/min) and during 75-W exercise (164 ± 3 vs. 131 ± 7 beats/min) (both P < 0.001). The change (upright supine) in SV was inversely correlated with the change in HR for all participants at rest (R 2 = 0.32), at 25 W (R2 = 0.49), 50 W (R2 = 0.60), and 75 W (R2 = 0.32) (P < 0.01). These results suggest that greater elevation in HR in POTS patients during exercise, especially while upright, was secondary to reduced SV and associated with exercise intolerance.

Original languageEnglish (US)
Pages (from-to)1128-1135
Number of pages8
JournalJournal of Applied Physiology
Volume103
Issue number4
DOIs
StatePublished - Oct 2007

Fingerprint

Postural Orthostatic Tachycardia Syndrome
Stroke Volume
Exercise
Cardiac Output
Arterial Pressure
Acetylene
Supine Position
Dizziness
Tachycardia
Vascular Resistance
Hypotension
Electrocardiography
Respiration

Keywords

  • Blood pressure
  • Cardiac output
  • Deconditioning
  • Orthostatic intolerance

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Masuki, S., Eisenach, J. H., Schrage, W. G., Johnson, C. P., Dietz, N. M., Wilkins, B. W., ... Joyner, M. J. (2007). Reduced stroke volume during exercise in postural tachycardia syndrome. Journal of Applied Physiology, 103(4), 1128-1135. https://doi.org/10.1152/japplphysiol.00175.2007

Reduced stroke volume during exercise in postural tachycardia syndrome. / Masuki, Shizue; Eisenach, John H.; Schrage, William G.; Johnson, Christopher P.; Dietz, Niki M.; Wilkins, Brad W.; Sandroni, Paola; Low, Phillip Anson; Joyner, Michael Joseph.

In: Journal of Applied Physiology, Vol. 103, No. 4, 10.2007, p. 1128-1135.

Research output: Contribution to journalArticle

Masuki, S, Eisenach, JH, Schrage, WG, Johnson, CP, Dietz, NM, Wilkins, BW, Sandroni, P, Low, PA & Joyner, MJ 2007, 'Reduced stroke volume during exercise in postural tachycardia syndrome', Journal of Applied Physiology, vol. 103, no. 4, pp. 1128-1135. https://doi.org/10.1152/japplphysiol.00175.2007
Masuki S, Eisenach JH, Schrage WG, Johnson CP, Dietz NM, Wilkins BW et al. Reduced stroke volume during exercise in postural tachycardia syndrome. Journal of Applied Physiology. 2007 Oct;103(4):1128-1135. https://doi.org/10.1152/japplphysiol.00175.2007
Masuki, Shizue ; Eisenach, John H. ; Schrage, William G. ; Johnson, Christopher P. ; Dietz, Niki M. ; Wilkins, Brad W. ; Sandroni, Paola ; Low, Phillip Anson ; Joyner, Michael Joseph. / Reduced stroke volume during exercise in postural tachycardia syndrome. In: Journal of Applied Physiology. 2007 ; Vol. 103, No. 4. pp. 1128-1135.
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