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A prospective study of excessive postural heart rate change on head-up tilt

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Abstract

Purpose

Healthy subjects with asymptomatic postural tachycardia (≥30 bpm) at baseline were evaluated over a 1-year period to determine whether they developed orthostatic symptoms.

Methods

Subjects were evaluated at baseline and at 1 year using the autonomic reflex screen and autonomic symptom profile (ASP).

Results

Heart rate increment on HUT did not differ at baseline (40.6 ± 7.5 bpm) or at 1 year (37.1 ± 11.1 bpm; n = 26; p > 0.05). Orthostatic symptoms measured by the ASP did not reveal significant orthostatic dysfunction throughout follow-up (baseline, 7.88 ± 7.61; 1 year, 9.04 ± 6.64; n = 26; p > 0.05). The ten autonomic domains of the ASP did not reveal a change in autonomic symptoms from baseline (13.56 ± 13.66) to 1-year follow-up (15.12 ± 11.62; n = 26; p > 0.05). Cardiovagal function was unchanged between baseline and follow-up for both heart rate variability to deep breathing (baseline, 23.9 ± 11.6 bpm; 1 year, 23.0 ± 9.3 bpm; n = 26; p > 0.05) and Valsalva ratio (baseline, 2.16 ± 0.39; 1 year, 2.15 ± 0.33; n = 26; p > 0.05).

Conclusions

These findings further argue that heart rate criteria (≥30 bpm) for Postural Tachycardia Syndrome (POTS) are not appropriate in younger individuals and higher postural heart rates do not predispose individuals to the development of POTS.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Neurological Sciences, London Health Sciences Centre, University Hospital, Rm. C7-131, 339 Windermere Road, London, ON, N6A 5A5, Canada

    James C. Corkal & Kurt Kimpinski

  2. Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Kurt Kimpinski

Authors
  1. James C. Corkal
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  2. Kurt Kimpinski
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Correspondence to Kurt Kimpinski.

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Corkal, J.C., Kimpinski, K. A prospective study of excessive postural heart rate change on head-up tilt. Clin Auton Res 24, 253–258 (2014). https://doi.org/10.1007/s10286-014-0254-x

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  • DOI: https://doi.org/10.1007/s10286-014-0254-x

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