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Postural orthostatic

Rogerio Ferreira Liporaci, Marcelo Camargo Saad, Julio César Crescêncio, Fabiana Marques, Debora Bevilaqua-Grossi, Lourenço Gallo-Júnior
BACKGROUND: Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an efficient postural control, to minimize body motion and facilitate venous return in a common type of syncope called neurocardiogenic syncope (NCS). Muscle activity in standing position may be registered by surface electromyography, and body sway confirmed by displacement of the center of pressure (COP) on a force platform. These peripheral variables reflect the role of muscles in the maintenance of orthostatism during the active tilt test, which, compared with muscle activity during the passive test (head-up tilt test), enables the analyses of electromyographic activity of these muscles that may anticipate the clinical effects of CNS during these tests...
January 2018: Arquivos Brasileiros de Cardiologia
Louise Brinth, Kirsten Pors, Jasmina Medic Spahic, Richard Sutton, Artur Fedorowski, Jesper Mehlsen
AIMS: The incidence of Postural Orthostatic Tachycardia Syndrome (POTS) has grown in recent years. Whether this is an emerging epidemic or increasing recognition is unclear. METHODS: We retrospectively examined 8790 tilt-table tests (HUT) performed between 1997 and 2014 in patients with orthostatic intolerance and/or suspected syncope. Tests were reclassified according to the current diagnostic criteria for POTS. The number of POTS diagnoses in proportion to the number of tilt tests performed per year was calculated...
March 3, 2018: Autonomic Neuroscience: Basic & Clinical
Zeljka Petelin Gadze, Andreja Bujan Kovac, Ivan Adamec, Nina Milekic, Vlatko Sulentic
No abstract text is available yet for this article.
March 6, 2018: Seizure: the Journal of the British Epilepsy Association
Amy C Arnold, Jessica Ng, Satish R Raj
Postural tachycardia syndrome (POTS) is a heterogeneous clinical syndrome that has gained increasing interest over the past few decades due to its increasing prevalence and clinical impact on health-related quality of life. POTS is clinically characterized by sustained excessive tachycardia upon standing that occurs in the absence of significant orthostatic hypotension and other medical conditions and or medications, and with chronic symptoms of orthostatic intolerance. POTS represents one of the most common presentations of syncope and presyncope secondary to autonomic dysfunction in emergency rooms and in cardiology, neurology, and primary care clinics...
February 28, 2018: Autonomic Neuroscience: Basic & Clinical
Maria Roma, Colleen L Marden, Inge De Wandele, Clair A Francomano, Peter C Rowe
OBJECTIVE: To review the association between orthostatic intolerance syndromes and both joint hypermobility and Ehlers-Danlos syndrome, and to propose reasons for identifying hereditary connective tissue disorders in those with orthostatic intolerance in the context of both clinical care and research. METHODS: We searched the published peer-reviewed medical literature for papers reporting an association between joint hypermobility or Ehlers-Danlos syndrome and orthostatic intolerance...
March 5, 2018: Autonomic Neuroscience: Basic & Clinical
Andrew P Owens, David A Low, Hugo D Critchley, Christopher J Mathias
Cognitive and emotional processes are influenced by interoception (homeostatic somatic feedback), particularly when physiological arousal is unexpected and discrepancies between predicted and experienced interoceptive signals may engender anxiety. Due to the vulnerability for comorbid psychological symptoms in forms of orthostatic intolerance (OI), this study investigated psychophysiological contributions to emotional symptomatology in 20 healthy control participants (13 females, mean age 36 ± 8 years), 20 postural tachycardia syndrome (PoTS) patients (18 females, mean age 38 ± 13 years) and 20 vasovagal syncope (VVS) patients (15 females, mean age 39 ± 12 years)...
January 31, 2018: Autonomic Neuroscience: Basic & Clinical
R B Guimarães, V Essebag, M Furlanetto, J P G Yanez, M G Farina, D Garcia, E D Almeida, L Stephan, G G Lima, T L L Leiria
We described the clinical evolution of patients with structural heart disease presenting at the emergency room with syncope. Patients were stratified according to their syncope etiology and available scores for syncope prognostication. Cox proportional hazard models were used to investigate the relationship between etiology of the syncope and event-free survival. Of the 82,678 emergency visits during the study period, 160 (0.16%) patients were there due to syncope, having a previous diagnosis of structural heart disease...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Ashley N Junghans-Rutelonis, Julia R Craner, Chelsea M Ale, Cynthia Harbeck-Weber, Philip R Fischer, Karen E Weiss
Intensive pain rehabilitation programs are effective in increasing functioning for youth with chronic pain (CP). However, the utility of such programs for youth with CP and co-morbid postural orthostatic tachycardia syndrome (POTS) is rarely examined. In addition, studies examining mediators of treatment for CP are sparse. This paper compares treatment outcomes for youth with CP (n = 117) and youth with CP + POTS (n = 118). Additionally, depression and pain catastrophizing were tested as potential mediators of treatment effects...
March 5, 2018: Journal of Clinical Psychology in Medical Settings
Jangsup Moon, Do-Yong Kim, Woo-Jin Lee, Han Sang Lee, Jung-Ah Lim, Tae-Joon Kim, Jin-Sun Jun, Byeongsu Park, Jung-Ick Byun, Jun-Sang Sunwoo, Soon-Tae Lee, Keun-Hwa Jung, Kyung-Il Park, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu
Postural tachycardia syndrome (POTS) is a form of dysautonomia which presents with complex symptoms including orthostatic intolerance. Several medications are prescribed for POTS; however, the efficacy of sustained medical treatment has not been well-investigated. Here, we conducted a 2 × 2 factorial design, randomized, clinical trial of a 3-month medical treatment regimen in POTS patients. Patients were randomly allocated to 4 treatment groups (Group 1: propranolol; Group 2: bisoprolol; Group 3: propranolol + pyridostigmine; Group 4: bisoprolol + pyridostigmine)...
March 2, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Mohammed Ruzieh, Blair P Grubb
Postural tachycardia syndrome (POTS) is a chronic condition characterized by symptoms of orthostatic intolerance. Pregnancy can cause different physiological changes in cardiovascular parameters, that could have greater impact on POTS patients. In this review, we discuss the management of POTS in the pregnant and obstetric settings.
February 16, 2018: Autonomic Neuroscience: Basic & Clinical
José M Martín, Catalina Torres, Pilar Cordero, Sara Sánchez, Liria Terradez, Dolores Ramón
Bascule syndrome is a recently described benign vasomotor dermatosis characterized by Bier anemic spots, cyanosis, and urticaria-like eruption. We report a case of a 13-year-old girl with cutaneous lesions consistent with Bascule syndrome who had had three exercise-related syncopal episodes. It would be recommended to exclude orthostatic intolerance or postural orthostatic tachycardia syndrome when evaluating patients with Bascule syndrome.
February 13, 2018: Pediatric Dermatology
Kassem Sharif, Abdulla Watad, Nicola Luigi Bragazzi, Michael Lichtbroun, Mariano Martini, Carlo Perricone, Howard Amital, Yehuda Shoenfeld
Chronic fatigue syndrome (CFS) is a heterogeneous disease which presents with pronounced disabling fatigue, sleep disturbances, and cognitive impairment that negatively affects patients' functional capability. CFS remains a poorly defined entity and its etiology is still in question. CFS is neither a novel diagnosis nor a new medical condition. From as early as the eighteenth century, a constellation of perplexing symptoms was observed that resembled symptoms of CFS. Commencing with "febricula" and ending with CFS, many names for the disease were proposed including neurocirculatory asthenia, atypical poliomyelitis, Royal Free disease, effort syndrome, Akureyri disease, Tapanui disease, chronic Epstein-Barr virus syndrome, and myalgic encephalitis...
February 7, 2018: Clinical Rheumatology
Wei Bai, Si-Yao Chen, Hong-Fang Jin, Jun-Bao Du
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance, and its incidence in children is approximately 6.8% [1]. The pathogenesis of POTS is complex with multiple, overlapping, interacting pathophysiological mechanisms. Although the specific pathogenic mechanism has remained perplexing, with the discovery of various gasotransmitters and biological peptides, the vascular dysfunction has aroused overwhelming attention. DATA SOURCES: On the basis of searching in a wide range of recent original literatures, we reviewed the pathogenesis of vascular dysfunction in children with POTS...
February 6, 2018: World Journal of Pediatrics: WJP
Jeffrey R Boris, Thomas Bernadzikowski
OBJECTIVE: The aim of this study was to identify and evaluate demographic and clinical features of paediatric patients with postural orthostatic tachycardia syndrome in a tertiary hospital speciality clinic. METHOD: This is a retrospective review of clinical data obtained during initial outpatient evaluation. RESULTS: A total of 708 patients met the evaluation criteria. Female patients outnumbered males, 3.45:1. Caucasians were over-represented at 94...
January 23, 2018: Cardiology in the Young
Gabriel D Rodrigues, Jonas L Gurgel, Thiago R Gonçalves, Flávia Porto, Pedro Paulo da S Soares
AIM: To investigate the influence of breathing patterns and blood pressure behavior postural control in older adults. METHODS: A total of 20 older adults carried out spontaneous, controlled (15 cycles/min) and deep (6 cycles/min) breathing trials, in random order. In this session, the heart rate was recorded continuously and blood pressure measured every 3 min. In addition, the challenge from sitting to an active standing position was carried out with eyes closed during 6 min on a baropodometer plate with electromyography recording...
January 22, 2018: Geriatrics & Gerontology International
Jacquie Baker, Juan M Racosta, Brittany Balint, Kurt Kimpinski
PURPOSE: The clinical significance of heart rate variability in the context of autonomic dysfunction continues to be a matter of debate. A consensus is lacking on the best heart rate variability measures for clinical purposes. Therefore, the purpose of this study was to investigate the utility of heart rate variability parameters in healthy versus autonomic dysfunction. METHODS: Healthy young (n = 134), healthy older (n = 32), and patients with mild (postural tachycardia syndrome; n = 25) and severe (neurogenic orthostatic hypotension; n = 34) autonomic dysfunction were included...
January 16, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Sjoerd T Timmermans, Esmee M Reijnierse, Jantsje H Pasma, Marijke C Trappenburg, Gerard J Blauw, Andrea B Maier, Carel G M Meskers
BACKGROUND: Orthostatic hypotension (OH), a blood pressure drop after postural change, is associated with impaired standing balance and falls in older adults. This study aimed to assess the association between blood pressure (BP) and a measure of quality of standing balance, i.e. Center of Pressure (CoP) movement, after postural change from supine to standing position in geriatric outpatients, and to compare CoP movement between patients with and without OH. METHODS: In a random subgroup of 75 consecutive patients who were referred to a geriatric outpatient clinic, intermittent BP measurements were obtained simultaneously with CoP measurements in mediolateral and anterior-posterior direction directly after postural change during 3 min of quiet stance with eyes open on a force plate...
January 15, 2018: BMC Geriatrics
Christopher Hazlett, Heather Edgell
Orthostatic intolerance is more common in women than men, and some studies have found that women in the early follicular (EF) phase of the menstrual cycle experience the greatest feelings of lightheadedness. Chemoreflex function while supine or upright was investigated to determine the potential contribution of ventilatory control to these phenomena. Men (n = 13) and women (n = 14) were tested while supine and 70° upright (head-up tilt [HUT]) and given: (1) normoxia or (2) hypercapnia (5% CO2 ). Women were tested during the EF phase (days 2-5) and the midluteal phase (ML; days 18-24)...
January 2018: Physiological Reports
Lucas Ithamar, Alberto Galvão de Moura Filho, Marco Aurélio Benedetti Rodrigues, Kelly Cristina Duque Cortez, Vinícius Gomes Machado, Claudia Regina Oliveira de Paiva Lima, Eduarda Moretti, Andrea Lemos
INTRODUCTION: Abdominal hypopressive gymnastics appeared as an alternative to traditional abdominal exercises to promote abdominal muscles strength without overloading the pelvic floor muscles (PFM). To determine the activation level of abdominal muscles and PFM and the posture influence in the level of activation in these muscles during abdominal hypopressive gymnastics, we used surface electromyography in young and healthy multipara women. METHODS: This is an observational study with eutrophic nulliparous women aged between 18 and 35 years, with abdominal skinfold less than or equal to 3 cm and active or irregularly active physical activity...
January 2018: Journal of Bodywork and Movement Therapies
Andrew P Owens, Karl J Friston, David A Low, Christopher J Mathias, Hugo D Critchley
Predictive coding models, such as the 'free-energy principle' (FEP), have recently been discussed in relation to how interoceptive (afferent visceral feedback) signals update predictions about the state of the body, thereby driving autonomic mediation of homeostasis. This study appealed to 'interoceptive inference', under the FEP, to seek new insights into autonomic (dys)function and brain-body integration by examining the relationship between cardiac interoception and autonomic cardiac control in healthy controls and patients with forms of orthostatic intolerance (OI); to (i) seek empirical support for interoceptive inference and (ii) delineate if this relationship was sensitive to increased interoceptive prediction error in OI patients during head-up tilt (HUT)/symptom provocation...
January 9, 2018: Autonomic Neuroscience: Basic & Clinical
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