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Differences in neurohumoral and hemodynamic response to prolonged head-up tilt between patients with high and normal standing norepinephrine forms of postural orthostatic tachycardia syndrome.
Auton Neurosci. 2017 07; 205:110-114.AN

Abstract

OBJECTIVE

To investigate the optimal timing for blood sample collection of catecholamines and the possible correlations between neurohumoral and hemodynamic responses to prolonged head-up tilt (HUT) in postural orthostatic tachycardia syndrome (POTS).

METHODS

Nineteen patients underwent a 30-minute, 70° HUT test. Blood samples (norepinephrine (NE), epinephrine and dopamine) were taken in the 10th minute of supine, and 10th, 20th and 30th minutes of HUT.

RESULTS

There were no significant differences in the proportion of high and normal standing NE patients in the different time points. Mean NE (nmol/L) values in 10th, 20th and 30th minute of HUT were 4.37, 4.87, and 4.35 in the high standing NE, and 2.49, 2.59 and 2.88 in the normal standing NE group. High standing NE patients had higher blood pressure (BP) during the first 6min of HUT (2nd minute after the HUT systolic BP (sBP): 118.29±15.65 vs. 95.70±13.43, p=0.004; diastolic BP (dBP): 78.71±6.68 vs. 65.10±9.04, p=0.003), while normal standing NE patients exhibited a drop in BP compared to resting values during the same time period. The normal standing NE group exhibited a progressive increase in norepinephrine values during the HUT.

CONCLUSION

One blood sample taken at the 10th minute of HUT correctly identifies high and normal standing NE POTS patients, but a small number of patients (1 out of 19, 5.2%) can be misidentified. High and normal standing NE POTS patients display distinctly different neurohumoral and hemodynamic responses to HUT.

Authors+Show Affiliations

School of Medicine, University of Zagreb, Zagreb, Croatia.University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.University Hospital Centre Zagreb, Department of Laboratory Diagnostics, Zagreb, Croatia.University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.School of Medicine, University of Zagreb, Zagreb, Croatia.University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.School of Medicine, University of Zagreb, Zagreb, Croatia; University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia. Electronic address: mhabek@mef.hr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28522107

Citation

Crnošija, Luka, et al. "Differences in Neurohumoral and Hemodynamic Response to Prolonged Head-up Tilt Between Patients With High and Normal Standing Norepinephrine Forms of Postural Orthostatic Tachycardia Syndrome." Autonomic Neuroscience : Basic & Clinical, vol. 205, 2017, pp. 110-114.
Crnošija L, Krbot Skorić M, Lovrić M, et al. Differences in neurohumoral and hemodynamic response to prolonged head-up tilt between patients with high and normal standing norepinephrine forms of postural orthostatic tachycardia syndrome. Auton Neurosci. 2017;205:110-114.
Crnošija, L., Krbot Skorić, M., Lovrić, M., Junaković, A., Miletić, V., Alfirev, R. Š., Pavelić, A., Adamec, I., & Habek, M. (2017). Differences in neurohumoral and hemodynamic response to prolonged head-up tilt between patients with high and normal standing norepinephrine forms of postural orthostatic tachycardia syndrome. Autonomic Neuroscience : Basic & Clinical, 205, 110-114. https://doi.org/10.1016/j.autneu.2017.05.007
Crnošija L, et al. Differences in Neurohumoral and Hemodynamic Response to Prolonged Head-up Tilt Between Patients With High and Normal Standing Norepinephrine Forms of Postural Orthostatic Tachycardia Syndrome. Auton Neurosci. 2017;205:110-114. PubMed PMID: 28522107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in neurohumoral and hemodynamic response to prolonged head-up tilt between patients with high and normal standing norepinephrine forms of postural orthostatic tachycardia syndrome. AU - Crnošija,Luka, AU - Krbot Skorić,Magdalena, AU - Lovrić,Mila, AU - Junaković,Anamari, AU - Miletić,Vladimir, AU - Alfirev,Rujana Šprljan, AU - Pavelić,Antun, AU - Adamec,Ivan, AU - Habek,Mario, Y1 - 2017/05/11/ PY - 2016/12/28/received PY - 2017/04/18/revised PY - 2017/05/10/accepted PY - 2017/5/20/pubmed PY - 2017/12/13/medline PY - 2017/5/20/entrez KW - Dopamine KW - Epinephrine KW - High standing NE KW - Norepinephrine KW - Postural orthostatic tachycardia syndrome SP - 110 EP - 114 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 205 N2 - OBJECTIVE: To investigate the optimal timing for blood sample collection of catecholamines and the possible correlations between neurohumoral and hemodynamic responses to prolonged head-up tilt (HUT) in postural orthostatic tachycardia syndrome (POTS). METHODS: Nineteen patients underwent a 30-minute, 70° HUT test. Blood samples (norepinephrine (NE), epinephrine and dopamine) were taken in the 10th minute of supine, and 10th, 20th and 30th minutes of HUT. RESULTS: There were no significant differences in the proportion of high and normal standing NE patients in the different time points. Mean NE (nmol/L) values in 10th, 20th and 30th minute of HUT were 4.37, 4.87, and 4.35 in the high standing NE, and 2.49, 2.59 and 2.88 in the normal standing NE group. High standing NE patients had higher blood pressure (BP) during the first 6min of HUT (2nd minute after the HUT systolic BP (sBP): 118.29±15.65 vs. 95.70±13.43, p=0.004; diastolic BP (dBP): 78.71±6.68 vs. 65.10±9.04, p=0.003), while normal standing NE patients exhibited a drop in BP compared to resting values during the same time period. The normal standing NE group exhibited a progressive increase in norepinephrine values during the HUT. CONCLUSION: One blood sample taken at the 10th minute of HUT correctly identifies high and normal standing NE POTS patients, but a small number of patients (1 out of 19, 5.2%) can be misidentified. High and normal standing NE POTS patients display distinctly different neurohumoral and hemodynamic responses to HUT. SN - 1872-7484 UR - https://www.unboundmedicine.com/medline/citation/28522107/Differences_in_neurohumoral_and_hemodynamic_response_to_prolonged_head_up_tilt_between_patients_with_high_and_normal_standing_norepinephrine_forms_of_postural_orthostatic_tachycardia_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1566-0702(16)30310-1 DB - PRIME DP - Unbound Medicine ER -