Stroke Volume and Not Exaggerated Peripheral Chemoreceptor Activity Drives Postural Hyperventilation in Female POTS Patients
نویسندگان
چکیده
Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic disorder of orthostatic intolerance that primarily (90-95%) affects premenopausal females. Patients experience debilitating symptoms, and excessive heart rate (HR) increases ≥30bpm within 10min standing without blood pressure (BP) drop (>20/10mmHg). exhibit postural hyper-ventilation (VE), leading to hypocapnia (i.e., low CO2). Hypocapnia exacerbates tachycardia symptoms. Previous research suggests VE driven by exaggerated peripheral chemoreceptor (pChR) activity. We hypothesized female POTS patients have greater reduction during pChR inhibition compared healthy controls (HC). 25 (age:31±8 years; mean±SD) 12 HC (age:31±6 p=0.8) completed randomized crossover trial hyperoxia vs. normoxia supine head-up tilt (HUT). Gender-based analyses were not possible as only 1 patient identified non-binary. To inhibit pChR, participants breathed 5x30sec bouts normocapnic (∼400mmHg). Breath-by-breath VE, ETO2, ETCO2 hemodynamics (HR, BP, stroke volume [SV], cerebral flow velocity [CBFv]) measured. Continuous variables using 3-factor mixed-effects model. hemodynamic relationships assessed linear regressions. ΔVE HUT was in (4.8±3.3L/min) (1.8±1.6L/min; p=0.001). inversely related ΔSV (r2=0.25; p=0.002), peak ΔCBFv (r2=0.11; p=0.04). During HUT, reduced both (p<0.001) (p<0.001). The magnitude ventilatory different between (-1.9±1.0 L/min) (-1.8±1.0 L/min; p=1.0). Our findings suggest SV CBFv activity drives hyperventilation POTS.
منابع مشابه
Postural tachycardia syndrome (POTS).
INTRODUCTION POTS is defined as the development of orthostatic symptoms associated with a heart rate (HR) increment >or=30, usually to >or=120 bpm without orthostatic hypotension. Symptoms of orthostatic intolerance are those due to brain hypoperfusion and those due to sympathetic overaction. METHODS We provide a review of POTS based primarily on work from the Mayo Clinic. RESULTS Females p...
متن کاملPostural tachycardia syndrome (POTS).
Postural Tachycardia Syndrome (POTS) Print ISSN: 0009-7322. Online ISSN: 1524-4539 Copyright © 2013 American Heart Association, Inc. All rights reserved. is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231 Circulation doi: 10.1161/CIRCULATIONAHA.112.144501 2013;127:2336-2342 Circulation. http://circ.ahajournals.org/content/127/23/2336 World Wide Web at: The ...
متن کاملBaroreceptor unloading in postural tachycardia syndrome augments peripheral chemoreceptor sensitivity and decreases central chemoreceptor sensitivity.
While orthostatic tachycardia is the hallmark of postural tachycardia syndrome (POTS), orthostasis also initiates increased minute ventilation (Ve) and decreased end-tidal CO(2) in many patients. We hypothesized that chemoreflex sensitivity would be increased in patients with POTS. We therefore measured chemoreceptor sensitivity in 20 POTS (16 women and 4 men) and 14 healthy controls (10 women ...
متن کاملPostural hypocapnic hyperventilation is associated with enhanced peripheral vasoconstriction in postural tachycardia syndrome with normal supine blood flow.
Previous investigations have demonstrated a subset of postural tachycardia syndrome (POTS) patients characterized by normal peripheral resistance and blood volume while supine but thoracic hypovolemia and splanchnic blood pooling while upright secondary to splanchnic hyperemia. Such "normal-flow" POTS patients often demonstrate hypocapnia during orthostatic stress. We studied 20 POTS patients (...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Canadian Journal of Cardiology
سال: 2023
ISSN: ['0828-282X', '1916-7075']
DOI: https://doi.org/10.1016/j.cjca.2023.02.062