Abstract
Aims
The incidence of Postural Orthostatic Tachycardia Syndrome (POTS) has grown in recent
years. Whether this is an emerging epidemic or increasing recognition is unclear.
Methods
We retrospectively examined 8790 tilt-table tests (HUT) performed between 1997 and
2014 in patients with orthostatic intolerance and/or suspected syncope. Tests were
reclassified according to the current diagnostic criteria for POTS. The number of
POTS diagnoses in proportion to the number of tilt tests performed per year was calculated.
The number of papers published with the term “Postural Orthostatic Tachycardia Syndrome”
1997–2014 was retrieved from PubMed and related to yearly POTS incidence.
Results
Eight-hundred-and-seventy-five tests with suspected POTS were thoroughly evaluated.
The reclassification of test results yielded 243 POTS diagnoses (age, 27.0 ± 11.8 years).
An increase in total number of POTS diagnoses was observed but the proportion of POTS-positive
tests per year was relatively constant (≈2–3%) except for the period 2013–2014 (≈7%).
The increase in POTS diagnoses was preceded by an increase in number of POTS-related
papers in PubMed.
Conclusion
The proportion of POTS diagnoses among patients investigated for suspected syncope
and/or orthostatic intolerance was relatively constant 1997–2012. The growing number
of POTS-related publications in PubMed preceded the steep increase in diagnostic rate
of POTS observed after 2012.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Autonomic Neuroscience: Basic and ClinicalAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A review of the evidence for overlap among unexplained clinical conditions.Ann. Intern. Med. 2001; 134: 868-881
- ‘The Italian Protocol’: a simplified head-up tilt testing potentiated with oral nitroglycerin to assess patients with unexplained syncope.Europace. 2000; 2: 339-342
- Postural tachycardia syndrome: a heterogeneous and multifactorial disorder.Mayo Clin. Proc. 2012; 87: 1214-1225
- Abnormal static circulatory phenomena and their symptoms: arterial orthostatic anemia as neglected clinical picture.Upsala Lakareforen. Forh. 1927; 33: 1-23
- Beyond myalgic encephalomyelitis/chronic fatigue syndrome: an IOM report on redefining an illness.JAMA. 2015; 313: 1101-1102
- Trends in the incidence of chronic fatigue syndrome and fibromyalgia in the UK, 2001–2013: a Clinical Practice Research Datalink study.J. R. Soc. Med. 2017; 110: 231-244
- Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study.BMC Fam. Pract. 2017; 18: 60
- On irritable heart: a clinical study of a form of a functional cardiac disorder and its consequences.Am J Med Sci. 1871; 61: 17-52
- Syndromes of orthostatic intolerance: a hidden danger.J. Intern. Med. 2013; 273: 322-335
- Antiadrenergic autoimmunity in postural tachycardia syndrome.Europace. 2017; 19: 1211-1219
- Postural tachycardia syndrome.Circulation. 2008; 117: 2814-2817
- Autonomic dysfunction presenting as postural orthostatic tachycardia syndrome in patients with multiple sclerosis.Int. J. Med. Sci. 2010; 7: 62-67
- Autoimmune basis for postural tachycardia syndrome.J. Am. Heart Assoc. 2014; 3e000755
- Criteria for environmentally associated autoimmune diseases.J. Autoimmun. 2012; 39: 253-258
- The hygiene hypothesis' for autoimmune and allergic diseases: an update.Clin. Exp. Immunol. 2010; 160: 1-9
- Comorbidity of postural orthostatic tachycardia syndrome and chronic fatigue syndrome in an Australian cohort.J. Intern. Med. 2014; 275: 409-417
- The epidemic of orthostatic tachycardia and orthostatic intolerance.Am J Med Sci. 1999; 317: 75-77
- Idiopathic postural orthostatic tachycardia syndrome: an attenuated form of acute pandysautonomia?.Neurology. 1993; 43: 132-137
- 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope.Heart Rhythm. 2015; 12e41-e63
- Ehlers-Danlos syndrome and postural tachycardia syndrome: a relationship study.J. Neurol. Sci. 2014; 340: 99-102
Article Info
Publication History
Published online: March 03, 2018
Accepted:
March 2,
2018
Received in revised form:
March 1,
2018
Received:
January 16,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
