Clinical improvement in patients with orthostatic intolerance after treatment with bisoprolol and fludrocortisone

• Type: Article in International Scientific Journal
• Date: 2000

Authors

Freitas, J (Author) FMUP; Santos, R (Author) Other; Elsa Azevedo (Author) Other; Ovídio Costa (Author) FMUP; Carvalho, M (Author) Other; de Freitas, AF (Author) Other

Journal

Title: Clinical Autonomic Research

Vol. 10

Pages: 293-299

ISSN: 0959-9851

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 51 Citations

Scopus - 67 Citations

Other information

Authenticus ID: P-000-YSZ

DOI: 10.1007/bf02281112

Abstract (EN): Orthostatic intolerance is the development of disabling symptoms upon assuming an upright posture that are relieved partially by resuming the supine position. Postural tachycardia syndrome (POTS) is an orthostatic intolerance syndrome characterized by palpitations because of excessive orthostatic sinus tachycardia, lightheadedness, tremor, and near-syncope. Patients usually undergo extensive medical, cardiac, endocrine, neurologic, and psychiatric evaluation, which usually fails to identify a specific abnormality. The authors investigated the autonomic and hemodynamic profile of patients with POTS and the effectiveness of bisoprolol and fludrocortisone. The authors evaluated II female patients with POTS before and after medical treatment with a cardioselective bisoprolol P-blocker or fludrocortisone, or both, and II age-matched control patients. Variability of heart rate and systolic blood pressure was assessed by fast Fourier transform, and spontaneons baroreceptor gain was assessed by use of the temporal sequences slope and a index. Modelflow was used to quantify hemodynamics. Symptoms in all patients improved greatly after medication. The autonomic and hemodynamic impairment observed in patients with POTS, particularly after orthostatic stress, is treated effectively with bisoprolol or fludrocortisone or both. These results need further confirmation in a controlled double-blind study. Proper medical treatment improves dramatically the clinical and autonomic-hemodynamic disturbances observed in patients with POTS. The data support the hypothesis that POTS is the result of a hyperadrenergic activation or hypovolemia during orthostasis.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7