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Effect of Food Intake on Hemodynamic Parameters during the Tilt-Table Test in Patients with Postural Orthostatic Tachycardia Syndrome

BACKGROUND AND PURPOSE: The aim of this study was to determine the effect of food intake on the heart rate (HR) in postural orthostatic tachycardia syndrome (POTS). METHODS: The following five-phase protocol was applied to 41 subjects who had a sustained HR increment of ≥30 beats/min within 10 min o...

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Detalles Bibliográficos
Autores principales: Habek, Mario, Ruška, Berislav, Crnošija, Luka, Adamec, Ivan, Junaković, Anamari, Krbot Skorić, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurological Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444156/
https://www.ncbi.nlm.nih.gov/pubmed/30877690
http://dx.doi.org/10.3988/jcn.2019.15.2.205
Descripción
Sumario:BACKGROUND AND PURPOSE: The aim of this study was to determine the effect of food intake on the heart rate (HR) in postural orthostatic tachycardia syndrome (POTS). METHODS: The following five-phase protocol was applied to 41 subjects who had a sustained HR increment of ≥30 beats/min within 10 min of standing in an initial tilt-table test: 1) 10-min supine phase, 2) 10-min 70°-tilted phase, 3) ingestion of 400 mL of Nutridrink Multi Fibre®, 4) 45-min supine phase, and 5) 10-min 70°-tilted phase. Subjects were divided into four groups: A) difference in HR for standing vs. supine (ΔHR) before the meal of ≥30 beats/min (n=13), B) ΔHR <30 beats/min before the meal but ≥30 beats/min after the meal (n=12), and C) ΔHR <30 beats/min both before and after the meal (n=16). Group D consisted of 10 healthy subjects. RESULTS: Before the meal, ΔHR was significantly higher in group A than in all of the other groups, and in group B than in group D (p<0.001). After the meal, ΔHR was significantly higher in groups A and B (p<0.001 and p<0.0001, respectively). When we pooled patients (according to their symptoms) from group A and B into a POTS group and from group C and D into a non-POTS group, an increase in HR of 25 beats/min before the meal had a sensitivity of 92.0% and a specificity of 80.8%. After the meal, an increase in HR of 30 beats/min had a sensitivity of 96.0% and a specificity of 96.2%. CONCLUSIONS: Food intake can significantly alter the results of the tilt-table test and so should be taken into account when diagnosing POTS.