Takikardia ortostatiko posturalaren fenotipo klinikoa, hartzaile adrenergikoen aurkako antigorputzei lotua
Year: 2023
Type: article
Study design: Observational Study
Abstract: Purpose: Our aim is to describe the clinical and hemodynamic characteristics of autoimmune postural orthostatic tachycardia syndrome (POTS), an entity whose frequency and clinical characteristics are not sufficiently defined yet.Methods: We retrospectively analyzed clinical, hemodynamic and serum autoimmunity biomarkers in 105 POTS patients and 79 age-sex-matched controls. We recorded clinical manifestations and relevant comorbidities. Participants underwent non-invasive quantitative cardiovascular autonomic testing by measuring changes in heart rate (HR) and blood pressure (BP), baroreflex sensitivity (BRS), total periph-eral resistance (TPR), stroke volume (SV) and cardiac index in response to deep breathing, valsalva maneuver, 60º head-up tilt, and quantitative evaluation of electrochemical skin conductance. In 61 POTS patients and 15 controls we quan-tified autoantibodies against adrenergic receptors (AR) alpha1 (anti-a1AR), beta1 (anti-b1AR), and beta2 (anti-b2AR) and antinuclear antibodies.Results: Joint hypermobility and chronic fatigue syndrome-fibromyalgia was significantly higher in POTS. We observed significant differences in cardiovascular autonomic tests with higher HR increase, lower TPR at 3 min in the tilt test, and higher BRS. AR antibodies were significantly higher in POTS (62%) than in controls (17%), with anti-a1AR in all antibody-positive POTS, 21.1% POTS had a combination of anti-a1AR with other AR antibodies. The presence of palpitations and orthostatic intolerance was significantly higher in anti-AR positive.Conclusion: Our results suggest that the prevalence of anti-AR antibodies is significantly higher in POTS, with the levels of such antibodies being correlated with the presence of symptoms associated with POTS.
Source: Gaceta Médica de Bilbao
Authors: Fernández-Valle, Tamara, Acera, Marian, Tijero, Beatriz, Pérez-Concha, Tomás, Del Pino, Rocío, Murueta-Goyena, Ane, Vicente-Lafuente, José, Boyero, Sabas, Ruiz-López, Marta, Martínez-Alday, Jesús-Daniel, Ugarte, Amaia, Ruiz-Irastorza, Guillermo, Ribacoba, Laureano, López-de-Munain, Adolfo, Gabilondo, Iñigo, Gómez-Esteban, Juan-Carlos
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7218048751