BACKGROUND:Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance associated with a significant symptom burden. Compression garments are a frequently prescribed treatment, but the effectiveness of waist-high compression has not been evaluated in adults with POTS. OBJECTIVES: This study evaluated compression garments as a treatment for POTS using a head-up tilt test (HUT), and a noninflatable core and lower body compression garment. METHODS:Thirty participants completed 10-min HUT with each of 4 compression conditions in a randomized crossover design. The conditions were no compression (NONE), lower leg compression (LEG), abdominal/thigh compression (ABDO), and full abdominal/leg compression (FULL). Heart rate, beat-to-beat blood pressure, and Vanderbilt Orthostatic Symptom Score ratings were measured during each HUT. RESULTS: The compression garment reduced heart rate (NONE: 109 ± 19 beats/min; LEG: 103 ± 16 beats/min; ABDO: 97 ± 15 beats/min; FULL: 92 ± 14 beats/min; p < 0.001) and improved symptoms (p < 0.001) during HUT in a dose-dependent manner. During HUT, stroke volume and systolic blood pressure were better maintained with FULL and ABDO compression compared with LEG and NONE compression. CONCLUSIONS: Abdominal and lower body compression reduced heart rate and improved symptoms during HUT in adult patients with POTS. These effects were driven by improved stroke volume with compression. Abdominal compression alone might also provide a clinical benefit if full lower body compression is not well tolerated. (Hemodynamic Effects of Compression in POTS; NCT03484273).
RCT Entities:
BACKGROUND:Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance associated with a significant symptom burden. Compression garments are a frequently prescribed treatment, but the effectiveness of waist-high compression has not been evaluated in adults with POTS. OBJECTIVES: This study evaluated compression garments as a treatment for POTS using a head-up tilt test (HUT), and a noninflatable core and lower body compression garment. METHODS: Thirty participants completed 10-min HUT with each of 4 compression conditions in a randomized crossover design. The conditions were no compression (NONE), lower leg compression (LEG), abdominal/thigh compression (ABDO), and full abdominal/leg compression (FULL). Heart rate, beat-to-beat blood pressure, and Vanderbilt Orthostatic Symptom Score ratings were measured during each HUT. RESULTS: The compression garment reduced heart rate (NONE: 109 ± 19 beats/min; LEG: 103 ± 16 beats/min; ABDO: 97 ± 15 beats/min; FULL: 92 ± 14 beats/min; p < 0.001) and improved symptoms (p < 0.001) during HUT in a dose-dependent manner. During HUT, stroke volume and systolic blood pressure were better maintained with FULL and ABDO compression compared with LEG and NONE compression. CONCLUSIONS: Abdominal and lower body compression reduced heart rate and improved symptoms during HUT in adult patients with POTS. These effects were driven by improved stroke volume with compression. Abdominal compression alone might also provide a clinical benefit if full lower body compression is not well tolerated. (Hemodynamic Effects of Compression in POTS; NCT03484273).
Authors: Kenneth A Mayuga; Artur Fedorowski; Fabrizio Ricci; Rakesh Gopinathannair; Jonathan Walter Dukes; Christopher Gibbons; Peter Hanna; Dan Sorajja; Mina Chung; David Benditt; Robert Sheldon; Mirna B Ayache; Hiba AbouAssi; Kalyanam Shivkumar; Blair P Grubb; Mohamed H Hamdan; Stavros Stavrakis; Tamanna Singh; Jeffrey J Goldberger; James A S Muldowney; Mark Belham; David C Kem; Cem Akin; Barbara K Bruce; Nicole E Zahka; Qi Fu; Erik H Van Iterson; Satish R Raj; Fetnat Fouad-Tarazi; David S Goldstein; Julian Stewart; Brian Olshansky Journal: Circ Arrhythm Electrophysiol Date: 2022-09-08
Authors: Amanda K Morrow; Laura A Malone; Christina Kokorelis; Lindsay S Petracek; Ella F Eastin; Katie L Lobner; Luise Neuendorff; Peter C Rowe Journal: Curr Pediatr Rep Date: 2022-03-09
Authors: Steven Vernino; Kate M Bourne; Lauren E Stiles; Blair P Grubb; Artur Fedorowski; Julian M Stewart; Amy C Arnold; Laura A Pace; Jonas Axelsson; Jeffrey R Boris; Jeffrey P Moak; Brent P Goodman; Kamal R Chémali; Tae H Chung; David S Goldstein; Andre Diedrich; Mitchell G Miglis; Melissa M Cortez; Amanda J Miller; Roy Freeman; Italo Biaggioni; Peter C Rowe; Robert S Sheldon; Cyndya A Shibao; David M Systrom; Glen A Cook; Taylor A Doherty; Hasan I Abdallah; Anil Darbari; Satish R Raj Journal: Auton Neurosci Date: 2021-06-05 Impact factor: 2.355