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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...

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Autores principales: Spahic, Jasmina Medic, Mattisson, Ingrid Yao, Hamrefors, Viktor, Johansson, Madeleine, Ricci, Fabrizio, Nilsson, Jan, Melander, Olle, Sutton, Richard, Fedorowski, Artur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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