Chronic orthostatic intolerance: part of a spectrum of dysfunction in orthostatic cardiovascular homeostasis?
Chronic orthostatic intolerance: part of a spectrum of dysfunction in orthostatic cardiovascular homeostasis?
复制标题
慢性直立不耐受：直立性心血管稳态功能障碍的一部分？
DOI：
10.1161/01.cir.98.20.2105
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发表时间：
1998
期刊：
影响因子：
37.8
通讯作者：
Somers,VK
中科院分区：
文献类型：
--
作者：
Narkiewicz,K;Somers,VK
慢性直立性不耐受(COI，又称体位性直立性心动过速综合征)是一种最常影响年轻女性的疾病(男女比例为4：1)。1主要症状包括头晕、心悸、疲劳、视力模糊、头晕、运动不耐受、胸部不适、认知障碍，偶尔还会晕厥。1、2这些症状通常发生在采取直立姿势后，并与快速发展的心动过速有关。心率每分钟增加30次或超过120次。血压通常只会有轻微的下降(如果有的话)。事实上，症状经常出现在没有任何降压的情况下，甚至是在站立时血压升高的情况下。2、3 COI的病因不明。这种疾病的发病往往早于最近的一次病毒感染。1、2相关情况包括二尖瓣脱垂、肠易激综合征和慢性疲劳。4提出的病理生理特征包括运动功能异常3和静脉张力受损引起的重力聚集过多。5人们普遍认为自主神经功能障碍是这种疾病的标志。
Chronic orthostatic intolerance (COI, also known as postural orthostatic tachycardia syndrome) is a disorder that most frequently affects young women (female-to-male ratio, 4: 1). 1 Presenting symptoms include lightheadedness, palpitations, fatigue, blurred vision, dizziness, exercise intolerance, chest discomfort, cognitive impairment, and occasionally syncope. 1, 2 These symptoms usually occur after upright posture is assumed and are associated with rapid development of tachycardia. Heart rate increases by 30 bpm or exceeds 120 bpm. There is usually only a modest, if any, fall in blood pressure. Indeed, symptoms frequently occur in the absence of any blood pressure reduction and even in the setting of an increase in blood pressure on standing. 2, 3 The cause of COI is unknown. The onset of the disorder is often predated by a recent viral infection. 1, 2 Associated conditions include mitral valve prolapse, irritable bowel syndrome, and chronic fatigue. 4 Proposed pathophysiological characteristics include abnormalities in sudomotor function3 and excessive gravitational pooling caused by impaired venous tone. 5 It is generally accepted that autonomic dysfunction is a hallmark of this disorder.