Body mass index is decreased in children and adolescents with postural tachycardia syndrome

Lin, Jen‐Der; Zhao, Huacai; Ma, Lei; Jiao, Fuyong

doi:10.24953/turkjped.2019.01.009

Cited by 9 publications

(14 citation statements)

References 19 publications

(23 reference statements)

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“…These findings were consistent with the epidemiological evidence of OD in Japan [8]. Previous studies have also shown that BMI tends to be lower in children with POTS than in healthy children [10], a finding also in line with those of the present study.…”

Section: Discussionsupporting

confidence: 94%

Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study

Yamanaka

Kasuga

et al. 2020

JCM

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Background and aim: Although head and/or neck pain attributed to orthostatic hypotension is included in international guidelines, its mechanisms and relevance remain unknown. This study examined the term’s relevance and aimed to elucidate the associated clinical features. Methods: An active stand test was performed to evaluate fluctuations in systemic and cerebral circulation in children and adolescents reporting complaints in the absence of a confirmed organic disorder. The subjects were categorized based on orthostatic headache presence/absence, and their characteristics and test results were compared. Results: Postural tachycardia syndrome was observed in 50.0% of children with, and 55.1% without, orthostatic headache. For orthostatic hypotension, the respective values were 31.3% and 30.6%. A history of migraine was more prevalent in children with orthostatic headaches (64.1% vs. 28.6%; p < 0.01). The observed decrease in the cerebral oxygenated hemoglobin level was larger in children with orthostatic headaches (Left: 6.3 (3.2–9.4) vs. 4.1 (0.8–6.1); p < 0.01, Right: 5.3 (3.1–8.6) vs. 4.0 (0.8–5.9); p < 0.01). Conclusion: Fluctuations in cerebral blood flow were associated with orthostatic headaches in children, suggesting that the headaches are due to impaired intracranial homeostasis. As orthostatic headache can have multiple causes, the term “head and/or neck pain attributed to orthostatic (postural) hypotension” should be replaced with a more inclusive term.

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Section: Discussionsupporting

confidence: 94%

Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study

Yamanaka

Kasuga

et al. 2020

JCM

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“…By including this wide range of body mass indices our data clearly support the recently published data from J Lin et al [9], who show that the body mass index is decreased in children with POTS. Accordingly, we found a high incidence of POTS in children with anorexia nervosa (11 from 43 patients, 25%), as recently published [10].…”

Section: Discussionsupporting

confidence: 90%

The postural orthostatic stress syndrome in childhood: HRV analysis and the active standing test

Julia¹,

Buchhorn²

2020

Prev Med Commun Health

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Background: Abnormalities in heart rate variability analysis (HRV) have been found in patients with postural orthostatic stress syndrome (POTS), indicating impaired autonomic function. We screened HRV in children in a 5-minute active standing test.Methods: 48 of nearly 500 (9.6%) screened children had a heart rate increase of more than 35 bpm on average in the first 5 minutes active standing test. These data are compared to well-defined indication groups: Healthy controls (N=47), Anorexia Nervosa (N=43), Obesity (N=52) and operated Congenital Heart Disease (N=38). 150 patients have additional 24-hours Holter ECG. Results:We found nearly no differences of supine and 24-hours heart rate and HRV between POTS patients and the healthy controls. However, there is a collapse of the vagus in the standing position indicated by a highly significant decrease of the HRV parameters RMSSD, pNN50, pNN20, High Frequency Power and the increase of the LF to HF ratio. Linear regression analysis show the significant impact of the patients height on the heart rate increase (T=5.9, p<0.0001) and an inverse impact of the body mass index (T= (-)2.33, p=0.021). Conclusion:We uncover the probably most important point of POTS physiology -the collapse of the vagus in the standing position. We identify the high-risk POTS patients -the tall lean teenagers and children with G-protein coupled receptor autoantibodies.

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“…They observed that BMI in the POTS group was significantly lower (18.3±3.4) than in VVS (20±4.2) and the control group [(20.5±2.9); P<0.05]. 15 Findings in our study were similar. This study observed no significant difference between the resting BP of the two groups; however, resting HR in the POTS group was significantly higher, which may be a result of autonomic imbalance characterized by increased cardiac sympathetic activity.…”

Section: Resultssupporting

confidence: 85%

“…They observed that the upright HR in the POTS group was significantly higher than the non-POTS group [32±12 bpm vs 22±7 bpm; P<0.01], and they also observed that the resting HR in the POTS group was significantly higher than non-POTS group [126±10 bpm vs 107±11 bpm; P<0.001]. 15 This study observed that the maximum upright increment in HR in adolescent diabetics with POTS was significantly higher than the non-POTS group (40.91±11.78 bpm vs 16.34±6.97 bpm; P<0.0001).…”

Section: Resultsmentioning

confidence: 99%

Role of NASA 10-minute Lean Test in diagnosing postural orthostatic tachycardia syndrome: a preliminary study in young population

et al. 2021

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Postural orthostatic tachycardia syndrome (POTS) is a form of autonomic imbalance characterized by abnormally increased heart rate (HR) and various symptoms of orthostatic intolerance (OI). This study aimed to determine POTS in adolescents using NASA 10-minute Lean Test. This crosssectional study was conducted at Government Medical College, Srinagar, J&K, India, between October 2017 and November 2019. Adolescents with symptoms of OI were enrolled for this study and NASA 10-minute Lean Test was performed. Characteristics of POTS group were the compared with non-POTS group. There was a significant difference in BMI (P< 0.0001) between POTS and non-POTS group. However, the number of females with features of POTS was greater than males. There was a significant difference in resting HR between the two groups (P<0.0001). During upright posture there was a significant difference in maximum upright HR between the two groups (P<0.0001), highest increment in upright HR also differed significantly (P<0.0001).POTS group had significantly higher HR than non-POTS group. It may be inferred from this preliminary study that NASA 10-minute Lean Test can be used to diagnose POTS.

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Body mass index is decreased in children and adolescents with postural tachycardia syndrome

Cited by 9 publications

References 19 publications

Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study

Orthostatic Headache in Children Including Postural Tachycardia Syndrome and Orthostatic Hypotension: A Near-Infrared Spectroscopy Study

The postural orthostatic stress syndrome in childhood: HRV analysis and the active standing test

Role of NASA 10-minute Lean Test in diagnosing postural orthostatic tachycardia syndrome: a preliminary study in young population

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