Abstract
Postural orthostatic tachycardia syndrome (POTS) is a multifactorial condition capable of chronically reducing the quality of life and the work ability of patients. The study aim was to assess the burden of autonomic symptoms in a cohort of POTS patients over 2 years. Patients’ clinical profiles were assessed by the 31-item Composite Autonomic Symptom Score questionnaire (COMPASS 31) and a visual analog scale (VAS). One-way ANOVA for repeated measures followed by Dunnett’s post-hoc test were used to compare symptoms at baseline and at 1 and 2 years. Out of 42 enrolled patients, 25 had a 1-year follow-up and 12 had a 2-year follow-up. At baseline, the reported burden of autonomic symptoms was high (overall COMPASS 31 = 49.9 ± 14.3 /100). Main complaints were related to orthostatic intolerance according to both COMPASS 31 and VAS. Fourteen patients were rendered inactive because of symptoms. At 1-year follow-up, a statistically significant improvement in pupillomotor function and overall score was detected by the COMPASS 31. These findings were confirmed at 2 years, together with a significant reduction in quality of life impairment, assessed by VAS. However, these improvements did not change patients’ occupational status. Awareness of POTS diagnosis, patient monitoring, and tailored therapies can help to improve patients’ condition.
Highlights
An increase in heart rate of ≥ 30 bpm, or ≥ 40 bpm for those under age 19, within 10 minutes of standing from a supine position; sustained tachycardia (> 30 s); absence of orthostatic hypotension; symptoms characterized by frequent occurrence and chronic duration (≥ 6 months)
Postural orthostatic tachycardia syndrome (POTS) was diagnosed at time of enrolment in 21 out of 42 patients
Our results indicate that POTS patients are characterized by a high burden of autonomic symptoms, as confirmed by the COMPASS 31 average total score of 49.9, out of a maximum of 100, reported in our population at baseline
Summary
Postural orthostatic tachycardia syndrome (POTS), named postural tachycardia syndrome, is a multifactorial cardiovascular autonomic disorder characterized by all of the following [1]: an increase in heart rate of ≥ 30 bpm, or ≥ 40 bpm for those under age 19, within 10 minutes of standing from a supine position; sustained tachycardia (> 30 s); absence of orthostatic hypotension (a fall in blood pressure of ≥ 20/10 mm Hg); symptoms characterized by frequent occurrence and chronic duration (≥ 6 months). Res. Public Health 2020, 17, 5872; doi:10.3390/ijerph17165872 www.mdpi.com/journal/ijerph
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