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Abnormal gastric myoelectrical activity in postural tachycardia syndrome

Clinical Autonomic Research volume 23, pages 73–80 (2013)Cite this article

Abstract

Objective

Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients.

Methods

Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years). We performed spectral analysis of EGG recordings to obtain the dominant frequency of gastric pacemaker rhythm (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power.

Results

Instability coefficient of DF, an index of variability of gastric pacemaker rhythm, was significantly elevated both pre- and post-prandially (30–45 min after the meal) in the PoTS group (8.8 ± 6, 10.0 ± 8 %) compared with controls (4.0 ± 3, 4.0 ± 3 %; both p < 0.05). Patients with GI symptoms had significantly higher post-prandial ICDF (15.0 ± 5 %) than those without GI symptoms (5.6 ± 4 %; p < 0.05). There were no significant differences in DF, LFR%, NFR% and HFR% before and after the meal between the PoTS and control groups, or between PoTS patients with and without GI symptoms.

Interpretation

Our study revealed increased variability of gastric pacemaker rhythm in PoTS, and these findings might be related to pathophysiology of functional GI symptoms in PoTS.

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Acknowledgments

We thank Madeline Tippetts, Michael Peche and Vanessa Ponnusamy for their support with the clinical testing of the patients.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Medicine, Autonomic and Neurovascular Medicine Unit, Imperial College London, 2nd Floor QEQM Wing, St. Mary’s Hospital, Praed Street, London, W2 1NY, UK

    William H. Seligman, David A. Low & Christopher J. Mathias

  2. Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK

    William H. Seligman

  3. Autonomic Unit National Hospital for Neurology & Neurosurgery Queen Square/ Division of Clinical Neurology Institute of Neurology , University College London, London, UK

    David A. Low & Christopher J. Mathias

  4. Department of Neurology, Chiba University School of Medicine, Chiba, Japan

    Masato Asahina

Authors
  1. William H. Seligman
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  2. David A. Low
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  3. Masato Asahina
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  4. Christopher J. Mathias
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Correspondence to William H. Seligman.

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Seligman, W.H., Low, D.A., Asahina, M. et al. Abnormal gastric myoelectrical activity in postural tachycardia syndrome. Clin Auton Res 23, 73–80 (2013). https://doi.org/10.1007/s10286-012-0185-3

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  • DOI: https://doi.org/10.1007/s10286-012-0185-3

Keywords

  • Orthostatic intolerance
  • Autonomic nervous system
  • Electrogastrography
  • Gastric motility