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Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study

PURPOSE: Eighty percent of patients infected by SARS-CoV-2 report persistence of one symptom beyond the 4-week convalescent period. Those with orthostatic tachycardia and orthostatic symptoms mimicking postural tachycardia syndrome, they are defined as Long-COVID POTS [LCP]. This case-control study...

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Autores principales: Rigo, Stefano, Urechie, Vasile, Diedrich, Andrè, Okamoto, Luis E., Biaggioni, Italo, Shibao, Cyndya A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481607/
https://www.ncbi.nlm.nih.gov/pubmed/37670400
http://dx.doi.org/10.1186/s42234-023-00121-6
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author Rigo, Stefano
Urechie, Vasile
Diedrich, Andrè
Okamoto, Luis E.
Biaggioni, Italo
Shibao, Cyndya A.
author_facet Rigo, Stefano
Urechie, Vasile
Diedrich, Andrè
Okamoto, Luis E.
Biaggioni, Italo
Shibao, Cyndya A.
author_sort Rigo, Stefano
collection PubMed
description PURPOSE: Eighty percent of patients infected by SARS-CoV-2 report persistence of one symptom beyond the 4-week convalescent period. Those with orthostatic tachycardia and orthostatic symptoms mimicking postural tachycardia syndrome, they are defined as Long-COVID POTS [LCP]. This case-control study investigated potential differences in autonomic cardiovascular regulation between LCP patients and healthy controls. METHODS: Thirteen LCP and 16 healthy controls, all female subjects, were studied without medications. Continuous blood pressure and ECG were recorded during orthostatic stress test, respiratory sinus arrhythmia, and Valsalva maneuver. Time domain and power spectral analysis of heart rate [HR] and systolic blood pressure [SBP] variability were computed characterizing cardiac autonomic control and sympathetic peripheral vasoconstriction. RESULTS: LCP had higher deltaHR (+ 40 ± 6 vs. + 21 ± 3 bpm, p = 0.004) and deltaSBP (+ 8 ± 4 vs. -1 ± 2 mmHg, p = 0.04) upon standing; 47% had impaired Valsalva maneuver ratio compared with 6.2% in controls (p = 0.01). Spectral analysis revealed that LCP had lower RMSSD (32.1 ± 4.6 vs. 48.9 ± 6.8 ms, p = 0.04) and HF(RRI), both in absolute (349 ± 105 vs. 851 ± 253ms(2), p = 0.03) and normalized units (32 ± 4 vs. 46 ± 4 n.u., p = 0.02). LF(SBP) was similar between groups. CONCLUSIONS: LCP have reduced cardiovagal modulation, but normal sympathetic cardiac and vasoconstrictive functions. Impaired parasympathetic function may contribute to the pathogenesis of Long-COVID POTS syndrome.
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spelling pubmed-104816072023-09-07 Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study Rigo, Stefano Urechie, Vasile Diedrich, Andrè Okamoto, Luis E. Biaggioni, Italo Shibao, Cyndya A. Bioelectron Med Short Report PURPOSE: Eighty percent of patients infected by SARS-CoV-2 report persistence of one symptom beyond the 4-week convalescent period. Those with orthostatic tachycardia and orthostatic symptoms mimicking postural tachycardia syndrome, they are defined as Long-COVID POTS [LCP]. This case-control study investigated potential differences in autonomic cardiovascular regulation between LCP patients and healthy controls. METHODS: Thirteen LCP and 16 healthy controls, all female subjects, were studied without medications. Continuous blood pressure and ECG were recorded during orthostatic stress test, respiratory sinus arrhythmia, and Valsalva maneuver. Time domain and power spectral analysis of heart rate [HR] and systolic blood pressure [SBP] variability were computed characterizing cardiac autonomic control and sympathetic peripheral vasoconstriction. RESULTS: LCP had higher deltaHR (+ 40 ± 6 vs. + 21 ± 3 bpm, p = 0.004) and deltaSBP (+ 8 ± 4 vs. -1 ± 2 mmHg, p = 0.04) upon standing; 47% had impaired Valsalva maneuver ratio compared with 6.2% in controls (p = 0.01). Spectral analysis revealed that LCP had lower RMSSD (32.1 ± 4.6 vs. 48.9 ± 6.8 ms, p = 0.04) and HF(RRI), both in absolute (349 ± 105 vs. 851 ± 253ms(2), p = 0.03) and normalized units (32 ± 4 vs. 46 ± 4 n.u., p = 0.02). LF(SBP) was similar between groups. CONCLUSIONS: LCP have reduced cardiovagal modulation, but normal sympathetic cardiac and vasoconstrictive functions. Impaired parasympathetic function may contribute to the pathogenesis of Long-COVID POTS syndrome. BioMed Central 2023-09-06 /pmc/articles/PMC10481607/ /pubmed/37670400 http://dx.doi.org/10.1186/s42234-023-00121-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Short Report
Rigo, Stefano
Urechie, Vasile
Diedrich, Andrè
Okamoto, Luis E.
Biaggioni, Italo
Shibao, Cyndya A.
Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title_full Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title_fullStr Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title_full_unstemmed Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title_short Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome – a case-control study
title_sort impaired parasympathetic function in long-covid postural orthostatic tachycardia syndrome – a case-control study
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481607/
https://www.ncbi.nlm.nih.gov/pubmed/37670400
http://dx.doi.org/10.1186/s42234-023-00121-6
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