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Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome
Background: Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous condition predominantly affecting autonomic control of the cardiovascular system. Its extensive symptom diversity implies multi-organ involvement that interacts in ways still requiring full exploration. Current understan...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380257/ https://www.ncbi.nlm.nih.gov/pubmed/37510775 http://dx.doi.org/10.3390/jcm12144660 |
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author | Spahic, Jasmina Medic Mattisson, Ingrid Yao Hamrefors, Viktor Johansson, Madeleine Ricci, Fabrizio Nilsson, Jan Melander, Olle Sutton, Richard Fedorowski, Artur |
author_facet | Spahic, Jasmina Medic Mattisson, Ingrid Yao Hamrefors, Viktor Johansson, Madeleine Ricci, Fabrizio Nilsson, Jan Melander, Olle Sutton, Richard Fedorowski, Artur |
author_sort | Spahic, Jasmina Medic |
collection | PubMed |
description | Background: Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous condition predominantly affecting autonomic control of the cardiovascular system. Its extensive symptom diversity implies multi-organ involvement that interacts in ways still requiring full exploration. Current understanding of POTS pathophysiology suggests alterations in the renin–angiotensin–aldosterone system as a possible contributing factor. Therefore, we investigated the relationship between the activity of the renin–angiotensin–aldosterone system and hemodynamic parameters in a cohort of POTS patients and controls recruited at a tertiary referral center. Methods: The case-control study included 46 patients with POTS (27 ± 9 years), and 48 healthy controls (30 ± 9 years) without orthostatic intolerance. Plasma renin activity, expressed as angiotensin I generation, and plasma aldosterone were measured by enzyme-linked immunosorbent assay and were correlated with hemodynamic parameters obtained during active standing tests. Results: Renin activity was significantly downregulated in POTS patients compared to healthy individuals (median, 3406 ng/mL vs. 9949 ng/mL, p < 0.001), whereas aldosterone concentration did not differ between POTS and healthy controls (median, 218 pmol/L vs. 218 pmol/L, p = 0.26). A significant inverse correlation between renin activity and supine and orthostatic blood pressure levels was observed in healthy individuals (p < 0.05 for all), but not in POTS patients. Conclusions: Renin activity, but not aldosterone concentration, is downregulated in patients with POTS. Moreover, renin activity in POTS is dissociated from supine and standing blood pressure levels in contrast to healthy individuals. These findings suggest impaired renin function in POTS, which may direct future therapeutic approaches. |
format | Online Article Text |
id | pubmed-10380257 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103802572023-07-29 Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome Spahic, Jasmina Medic Mattisson, Ingrid Yao Hamrefors, Viktor Johansson, Madeleine Ricci, Fabrizio Nilsson, Jan Melander, Olle Sutton, Richard Fedorowski, Artur J Clin Med Article Background: Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous condition predominantly affecting autonomic control of the cardiovascular system. Its extensive symptom diversity implies multi-organ involvement that interacts in ways still requiring full exploration. Current understanding of POTS pathophysiology suggests alterations in the renin–angiotensin–aldosterone system as a possible contributing factor. Therefore, we investigated the relationship between the activity of the renin–angiotensin–aldosterone system and hemodynamic parameters in a cohort of POTS patients and controls recruited at a tertiary referral center. Methods: The case-control study included 46 patients with POTS (27 ± 9 years), and 48 healthy controls (30 ± 9 years) without orthostatic intolerance. Plasma renin activity, expressed as angiotensin I generation, and plasma aldosterone were measured by enzyme-linked immunosorbent assay and were correlated with hemodynamic parameters obtained during active standing tests. Results: Renin activity was significantly downregulated in POTS patients compared to healthy individuals (median, 3406 ng/mL vs. 9949 ng/mL, p < 0.001), whereas aldosterone concentration did not differ between POTS and healthy controls (median, 218 pmol/L vs. 218 pmol/L, p = 0.26). A significant inverse correlation between renin activity and supine and orthostatic blood pressure levels was observed in healthy individuals (p < 0.05 for all), but not in POTS patients. Conclusions: Renin activity, but not aldosterone concentration, is downregulated in patients with POTS. Moreover, renin activity in POTS is dissociated from supine and standing blood pressure levels in contrast to healthy individuals. These findings suggest impaired renin function in POTS, which may direct future therapeutic approaches. MDPI 2023-07-13 /pmc/articles/PMC10380257/ /pubmed/37510775 http://dx.doi.org/10.3390/jcm12144660 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Spahic, Jasmina Medic Mattisson, Ingrid Yao Hamrefors, Viktor Johansson, Madeleine Ricci, Fabrizio Nilsson, Jan Melander, Olle Sutton, Richard Fedorowski, Artur Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title | Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title_full | Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title_fullStr | Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title_full_unstemmed | Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title_short | Evidence for Impaired Renin Activity in Postural Orthostatic Tachycardia Syndrome |
title_sort | evidence for impaired renin activity in postural orthostatic tachycardia syndrome |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380257/ https://www.ncbi.nlm.nih.gov/pubmed/37510775 http://dx.doi.org/10.3390/jcm12144660 |
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