The complexity of diagnosing postural orthostatic tachycardia syndrome: influence of the diurnal variability
The complexity of diagnosing postural orthostatic tachycardia syndrome: influence of the diurnal variability
复制标题
DOI：
10.1016/j.jash.2016.01.011
复制
发表时间：
2016-03-01
影响因子：
--
通讯作者：
Lee, Sang Kun
中科院分区：
文献类型：
--
作者：
Moon, Jangsup;Lee, Han Sang;Lee, Sang Kun
我们研究了体位性心动过速综合征(POTS)的诊断如何因立位性心动过速的昼夜变化而改变。入院当天下午和次日上午各进行两次立位生命体征试验(n=113)。46例患者被诊断为POTS，其余67例被分配为非POTS组。各组站立后上午心率增量均大于下午(均P<0.001)。在POTS患者中，82.6%的患者在上午符合POTS的诊断标准，52.2%的患者在下午符合POTS的诊断标准。大多数POTS组(65.2%)单次立位生命体征试验结果正常。只有45.7%的POTS患者出现立位不耐受症状，更常见的是在早上。总而言之，血流动力学参数的昼夜变异性和诱发症状对POTS的诊断提出了极大的挑战。(C)2016美国高血压学会。版权所有。
We investigated how the diagnosis of postural orthostatic tachycardia syndrome (POTS) would be changed due to diurnal variability in orthostatic tachycardia. The orthostatic vital sign test was administered to each patient twice, in the afternoon of the day of admission and the next morning (n = 113). Forty-six patients were diagnosed with POTS, and the remaining 67 patients were assigned to non-POTS group. Heart rate increments after standing were larger in the morning than in the afternoon in every group (all P < .001). Among the POTS patients, 82.6% fulfilled the diagnostic criteria for POTS in the morning and 52.2% in the afternoon. Most POTS group (65.2%) displayed normal result on single orthostatic vital sign test. Orthostatic intolerance symptoms were provoked in only 45.7% of the POTS patients, more frequently in the morning. In conclusion, diurnal variability in hemodynamic parameters and provoked symptoms significantly challenged the diagnosis of POTS. (C) 2016 American Society of Hypertension. All rights reserved.