Jacqueline Fannin, Kevin M Rice, Srininvas Thulluri, Ravi Kumar Arvapalli, Paulette Wehner, Eric R Blough
{"title":"The Effects of Aging on Indices of Oxidative Stress and Apoptosis in the Female Fischer 344/Nnia X Brown Norway/BiNia Rat Heart.","authors":"Jacqueline Fannin, Kevin M Rice, Srininvas Thulluri, Ravi Kumar Arvapalli, Paulette Wehner, Eric R Blough","doi":"10.2174/1874192401307010113","DOIUrl":"https://doi.org/10.2174/1874192401307010113","url":null,"abstract":"<p><p>Oxidative-nitrosative stress may play a role in age-associated cardiovascular disease as implied by recent studies.However, limited research has been conducted using aged female rodent models. In this study, we examined hearts obtained from 6-, 26-, and 30-month old female Fischer 344/Nnia x Brown Norway/BiNia (F344xBN) rats in order to examine how aging affects levels of cardiac oxidative-nitrosative stress and apoptosis. Oxidative (superoxide anion and 4-HNE) and nitrosative (protein nitrosylation) stress markers were increased 180 ± 17 %, 110 ± 3 %, and 14 ± 2 %, respectively in 30-month hearts compared to the hearts of 6-month female rats. Coincident with these changes in oxidative-nitrosative stress, aging was also found to be associated with increases in the number of Tdt-mediated dUTP nick labeling (TUNEL)-positive cardiomyocytes, alterations in the Bax/Bcl-2 ratio, and elevated cleavage of caspase-3. Regression analysis demonstrates significant correlation in the age-associated changes markers of oxidative-nitrosative stress with changes in apoptotic signaling. The findings from this descriptive study imply that age-associated increases in mitochondrial-mediated apoptosis may be associated with the increase in oxidative-nitrosative stress in the aging F344xBN female heart. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"113-21"},"PeriodicalIF":0.8,"publicationDate":"2013-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/23/TOCMJ-7-113.PMC3866772.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31973019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H Farhan, A Albulushi, A Taqi, A Al-Hashim, K Al-Saidi, K Al-Rasadi, A Al-Mazroui, I Al-Zakwani
{"title":"Incidence and pattern of thyroid dysfunction in patients on chronic amiodarone therapy: experience at a tertiary care centre in oman.","authors":"H Farhan, A Albulushi, A Taqi, A Al-Hashim, K Al-Saidi, K Al-Rasadi, A Al-Mazroui, I Al-Zakwani","doi":"10.2174/1874192401307010122","DOIUrl":"https://doi.org/10.2174/1874192401307010122","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence and pattern of thyroid dysfunction (TD) in patients on chronic amiodarone therapy.</p><p><strong>Methods: </strong>A retrospective study which evaluated 59 patients who had received amiodarone therapy regularly for at least 12 months from a period of 3 years from October 2007 to October 2010. The patients were followed-up at the cardiac clinic at Sultan Qaboos University Hospital, Muscat, Oman.</p><p><strong>Results: </strong>The mean age of the cohort was 63 ± 13 years ranging from 27 to 98 years. Fifty-one percent (n = 30) of the patients were female. There were 11 (19%) cases of thyroid dysfunction (TD). Seven (12%) patients were hypothyroid, 3 (5%) had hyperthyroidism and 1 (2%) patient had sub-clinical hypothyroidism; no cases of sub-clinical hyperthyroidism were noted. Female gender and presence of anti-thyroid peroxidase antibodies were significantly associated with amiodarone-induced hypothyroidism (p = 0.001) while age, amiodarone dose and duration of therapy were not correlated with the development of TD (all p-values > 0.05).</p><p><strong>Conclusion: </strong>Amiodarone-induced thyroid dysfunction is prevalent. Hypothyroidism was more frequent and seen more in female patients and those who had positive anti-thyroid peroxidase antibodies. Initial screening and periodic monitoring of thyroid function is mandatory for all patients on amiodarone therapy.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"122-6"},"PeriodicalIF":0.8,"publicationDate":"2013-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/fd/TOCMJ-7-122.PMC3866614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31972369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vijay Naraynsingh, Patrick Harnarayan, Ravi Maharaj, Dilip Dan, Seetharaman Hariharan
{"title":"Preoperative digital carotid compression as a predictor of the need for shunting during carotid endarterectomy.","authors":"Vijay Naraynsingh, Patrick Harnarayan, Ravi Maharaj, Dilip Dan, Seetharaman Hariharan","doi":"10.2174/1874192401307010110","DOIUrl":"https://doi.org/10.2174/1874192401307010110","url":null,"abstract":"<p><p>This study prospectively attempted to assess the need for shunting by preoperative digital compression of the proximal common carotid artery and correlated these findings with intraoperative assessment while performing carotid endarterectomy under local anaesthesia. Preoperative digital compression is highly predictive of the need for shunting intra-operatively and can be used as a valuable test in carefully chosen patients. This may help in decreasing the need for advanced neurological monitoring during carotid endarterectomy. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"110-2"},"PeriodicalIF":0.8,"publicationDate":"2013-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/e3/TOCMJ-7-110.PMC3866623.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31973018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manoefris Kasim, Geoffrey M Currie, Markus Tjahjono, Bambang B Siswanto, Ganesja M Harimurti, Hosen Kiat
{"title":"Myocardial Perfusion SPECT Utility in Predicting Cardiovascular Events Among Indonesian Diabetic Patients.","authors":"Manoefris Kasim, Geoffrey M Currie, Markus Tjahjono, Bambang B Siswanto, Ganesja M Harimurti, Hosen Kiat","doi":"10.2174/1874192401307010082","DOIUrl":"https://doi.org/10.2174/1874192401307010082","url":null,"abstract":"<p><strong>Background: </strong>Indonesia has the fourth largest number of diabetes patients after India, China and the USA. Coronary artery disease (CAD) is the most common cause of death in diabetic patients. Early detection and risk stratification is important for optimal management. Abnormal myocardial perfusion imaging (MPI) is an early manifestation in the ischemic cascade. Previous studies have demonstrated the use of MPI to accurately diagnose obstructive CAD and predict adverse cardiac events. This study evaluated whether MPI predicts adverse cardiac event in an Indonesian diabetic population.</p><p><strong>Method: </strong>The study was undertaken in a consecutive cohort of patients with suspected or known CAD fulfilling entry criteria. All had adenosine stress MPI. The end point was a major adverse cardiac event (MACE) defined as cardiac death or nonfatal myocardial infarction (MI).</p><p><strong>Results: </strong>Inclusion and exclusion criteria were satisfied by 300 patients with a mean follow-up of 26.7 ± 8.8 months. The incidence of MACEs was 18.3% among diabetic patients, versus 9% in the non-diabetic population (p < 0.001). A multivariable Cox proportional hazard model demonstratedin dependent predictors for a MACE as abnormal MPI [HR: 9.30 (3.01 - 28.72), p < 0.001], post stress left ventricular ejection fraction (LVEF) ≤30% [HR:2.72 (1.21 - 6.15), p = 0.016] and the patients diabetic status [HR:2.28 (1.04 - 5.01), p = 0.04]. The Kaplan Meier event free survival curve constructed for the different subgroups based on the patients' diabetic status and MPI findings demonstrated that diabetic patients with an abnormal MPI had the worst event free survival (log rank p value < 0.001).</p><p><strong>Conclusions: </strong>In an Indonesian population with suspected or known CAD abnormal adenosine stress MPI is an independent and potent predictor for adverse cardiovascular events and provides incremental prognostic value in cardiovascular risk stratification of patients with diabetes.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":" ","pages":"82-9"},"PeriodicalIF":0.8,"publicationDate":"2013-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/b8/TOCMJ-7-82.PMC3795403.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40262087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Konstantinos Dean Boudoulas, Yazhini Ravi, Daniel Garcia, Uksha Saini, Gbemiga G Sofowora, Richard J Gumina, Chittoor B Sai-Sudhakar
{"title":"Type of Valvular Heart Disease Requiring Surgery in the 21st Century: Mortality and Length-of-Stay Related to Surgery.","authors":"Konstantinos Dean Boudoulas, Yazhini Ravi, Daniel Garcia, Uksha Saini, Gbemiga G Sofowora, Richard J Gumina, Chittoor B Sai-Sudhakar","doi":"10.2174/1874192420130902001","DOIUrl":"https://doi.org/10.2174/1874192420130902001","url":null,"abstract":"<p><strong>Aim: </strong>While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital.</p><p><strong>Methods: </strong>Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed.</p><p><strong>Results: </strong>From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac proce-dures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery).</p><p><strong>Conclusions: </strong>Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"104-9"},"PeriodicalIF":0.8,"publicationDate":"2013-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/35/TOCMJ-7-104.PMC3856389.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31956169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparative Effects of Preoperative Angiotensin-converting Enzyme In-hibitor, Statin and Beta-blocker Treatment on Human Internal Mammary Artery Reactivity in Patients with Coronary Artery Disease: A Pilot Study.","authors":"Selvinaz Dalaklioglu, Ilhan Golbasi, Caglar Ogutman","doi":"10.2174/1874192401307010069","DOIUrl":"https://doi.org/10.2174/1874192401307010069","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the effect of angiotensin-converting enzyme (ACE)- inhibitor, statin, and beta-blocker usage before coronary bypass surgery (CABG) on vascular reactivity of the internal mammary artery (IMA).</p><p><strong>Methods: </strong>Patients, who underwent elective CABG were evaluated. Samples of IMA obtained from 22 patients were divided into 4 groups in respect of drugs used by patients before bypass surgery (control group, ACE inhibitor + statin group, ACE inhibitor + statin + beta-blocker group, and ACE inhibitor + beta-blocker group). The discarded, distal end section of IMA was carefully removed, and the vasoreactivity of IMA rings was evaluated in vitro using an organ chamber. Smooth muscle contractile function was tested on artery segments exposed to 10-80 mM KCl and norepinephrine. The endothelial function of IMA rings was assessed with acetylcholine (ACh) and bradykinin, while endothelium-independent vasorelaxation was evaluated by sodium nitroprusside (SNP).</p><p><strong>Results: </strong>Both ACh and bradykinin caused concentration-dependent relaxation in endothelium-intact IMA rings. However, the maximal effect produced by endothelium-dependent agents in all treatment groups was more prominent when compared with the control group. There was no significant difference in the endothelium-dependent relaxation response of IMA between ACE inhibitor + statin, ACE inhibitor + beta-blocker and ACE inhibitor + statin + beta-blocker groups. The vasodilatory potency of SNP was similar in all groups. Similarly, contractile response to KCl or norepinephrine was not significantly different between groups.</p><p><strong>Conclusion: </strong>Use of ACE inhibitors and statins before bypass surgery may influence IMA vasoreactivity by improving endothelial control of vascular tone.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"69-75"},"PeriodicalIF":0.8,"publicationDate":"2013-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/24/TOCMJ-7-69.PMC3772568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31740025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberta Buso, Marcello Rattazzi, Matteo Leoni, Massimo Puato, Francesco Di Paola, Paolo Pauletto
{"title":"An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment.","authors":"Roberta Buso, Marcello Rattazzi, Matteo Leoni, Massimo Puato, Francesco Di Paola, Paolo Pauletto","doi":"10.2174/1874192401307010050","DOIUrl":"https://doi.org/10.2174/1874192401307010050","url":null,"abstract":"<p><p>Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-inflammatory and non-atherosclerotic disease that affects arterial walls, leading to stenosis of small and medium-sized arteries. FMD mostly involves renal and intracranial arteries and only in few patients is associated with macroaneurysms (RAAs). We present the case of a 45-years old woman with recent history of grade 2 hypertension that suffered of subarachnoid haemorrhage due to rupture of a basilar artery aneurysm. The cerebral aneurysm was immediately treated by coil embolization and an abdominal angio-CT scan was performed to investigate the presence of renovascular hypertension. The exam showed the presence of FMD of the renal arteries associated with presence of bilateral RAAs. Due to the high risk of rupture, the bigger aneurysm (2,5 cm diameter) present on the left artery was immediately treated by coil embolization. The fusiform aneurysm, present on the right renal artery, was instead treated one year later by using two flow diverter stents. After three years, an angiographic study showed that both cerebral and renal aneurysms were excluded from the blood flow without evidence of arterial restenosis. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"50-3"},"PeriodicalIF":0.8,"publicationDate":"2013-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/3a/TOCMJ-7-50.PMC3772574.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31740784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donatella Mecchia, Anna Maria Lavezzi, Luigi Matturri
{"title":"Primary Cardiac Fibroma and Cardiac Conduction System Alterations in a Case of Sudden Death of a 4-month-old Infant.","authors":"Donatella Mecchia, Anna Maria Lavezzi, Luigi Matturri","doi":"10.2174/1874192401307010047","DOIUrl":"https://doi.org/10.2174/1874192401307010047","url":null,"abstract":"<p><p>A 4-month-old female infant considered to be in good health died suddenly and unexpectedly. Post- mortem examination was requested, with clinical diagnosis of sudden infant death syndrome. At autopsy the infant was described in good health. Histo- logical examination of the heart found a cardiac fibroma compressing the atrio-ventricular node and the examination of the cardiac conduction system showed an accessory fiber of Mahaim (nodo-ventricular) and cartilaginous metaplasia of the cardiac fibrous body. Probably the concomitant presence of cardiac conduction system abnormalities and a septal fibroma, compressing the atrio-ventricular node, could have an important role in causing the sudden death. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"47-9"},"PeriodicalIF":0.8,"publicationDate":"2013-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/58/TOCMJ-7-47.PMC3706798.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31216621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Konstantinos C Koskinas, Leonidas Lillis, Antonios Ziakas
{"title":"Diltiazem: a reversible cause of atrioventricular block - until proven otherwise.","authors":"Konstantinos C Koskinas, Leonidas Lillis, Antonios Ziakas","doi":"10.2174/1874192401307010046","DOIUrl":"https://doi.org/10.2174/1874192401307010046","url":null,"abstract":"Drugs are considered a common reversible cause of rhythm conduction disorders. Atrio-ventricular (AV) block occurs more commonly following β-blocker or digitalis administration, but calcium channel blockers have also been linked to AV block [1,2] The cornerstone of management in drug-related AV block is to determine whether the AV block is truly reversible upon withdrawal of the culprit drug, hence implantation of a permanent pacemaker can be avoided. \u0000 \u0000Brenes and colleagues report an interesting case of complete AV block in an elderly patient who received diltiazem [3]. The patient’s deteriorating renal function and his advanced age were considered as possible precipitating factors of diltiazem-induced AV conduction abnormality. The AV block resolved following intravenous calcium administration. While the temporal sequence of drug interruption, calcium administration, and sinus rhythm restoration in this case3 indeed strongly suggests a cause-and-effect relation between diltiazem and AV block, some caution is still required. Previous evidence from large case series indicates that the majority of patients for whom drug discontinuation leads to resolution of AV block have recurrence of AV block in the absence of therapy [4,5]. Conversely, drug discontinuation is followed by resolution of AV block in 41% of cases, but spontaneous improvement of AV conduction also occurs in 23% of patients who have AV block in the absence of drugs [4], suggesting that resolution of AV block upon drug interruption does not necessarily prove that the AV block represents an exclusively adverse drug effect of the AV blocker. In fact, it has been reported that AV block is truly caused by drugs in only 15% of patients with 2nd 3rd degree AV block during therapy with beta-blockers, verapamil or diltiazem.6 In most patients receiving AV blockers, AV block may actually be triggered due to underlying AV conduction disease [6]. As a consequence of the high risk of AV block recurrence despite the discontinuation of the suspected culprit drug, about half of patients who receive AV blockers and develop AV block ultimately require implantation of a permanent pacemaker [6]. \u0000 \u0000In conclusion, in patients receiving drugs that affect AV conduction AV block is very likely to be merely drug-related rather than truly drug-induced. Therefore, AV blocking drugs should be considered as reversible causes of benign, intermittent AV block, but only until proven otherwise.","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"46"},"PeriodicalIF":0.8,"publicationDate":"2013-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/f7/TOCMJ-7-46.PMC3715753.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31600757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kenneth A Mayuga, Christopher E Gaw, Curtis Tatsuoka, Fetnat Fouad-Tarazi
{"title":"Characteristics of heart rate reduction with resumption of supine position in the postural tachycardia syndrome: factors influencing recovery.","authors":"Kenneth A Mayuga, Christopher E Gaw, Curtis Tatsuoka, Fetnat Fouad-Tarazi","doi":"10.2174/1874192401307010036","DOIUrl":"https://doi.org/10.2174/1874192401307010036","url":null,"abstract":"<p><strong>Objectives: </strong>Postural orthostatic tachycardia syndrome (POTS), a heart rate (HR) rise with upright positioning, is dependent on autonomic influences. HR recovery (HR decrease after exercise cessation) is a measure of autonomic function. Characteristics of HR reduction during supine Recovery after head-up Tilt in POTS patients have not been elucidated.</p><p><strong>Methods: </strong>113 subjects (mean age 41.7 years, 86 female), diagnosed with POTS on head-up Tilt were analyzed. HR's were recorded during baseline supine position, 70-degree Tilt, and 20 sec, 1 min and 2 min of supine Recovery. Percent HR reduction during Recovery was calculated.</p><p><strong>Results: </strong>Baseline HR was 68.7±13.4 bpm. Maximum HR during Tilt was 109±16.9 bpm. Mean HR was 84.2±20 bpm at 20 sec, 78.5±18.9 bpm at 1-min, and 77.1±18.3 bpm at 2 min of Recovery. Younger age and slower baseline HR were associated with greater HR reductions at 20 sec (p=0.006, p=0.000, respectively). Younger age, slower baseline HR and less time to achieve POTS were associated with greater HR reductions at 1 min (p=0.025, p=0.000, p=0.000, respectively) and at 2 min (p=0.004, p=0.000, p=0.000, respectively). Gender and baseline blood pressures were not significant.</p><p><strong>Conclusions: </strong>In POTS patients, HR quickly decreases upon resuming supine position. Younger age, slower baseline HR and less time to achieve POTS were associated with greater HR reductions during supine Recovery. Further study is needed to determine mechanisms, as well as analyze differences in symptoms or prognosis.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"7 ","pages":"36-9"},"PeriodicalIF":0.8,"publicationDate":"2013-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/a1/TOCMJ-7-36.PMC3680982.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31626953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}