Postural Tachycardia Syndrome (POTS).
Journal: Heart Rhythm. 2012 May 3. [Epub ahead of print]
Coffin ST, Black BK, Biaggioni I, Paranjape SY, Orozco C, Black PW, Dupont
WD, Robertson D, Raj SR.
Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department
of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Abstract
BACKGROUND:
Postural Tachycardia Syndrome (POTS) induces disabling chronic orthostatic
intolerance with an excessive increase in heart rate (HR) upon standing, and
many POTS patients have low blood volume. Increasing blood volume is a
promising approach to this problem.
OBJECTIVE:
We tested the hypothesis that desmopressin (DDAVP) will attenuate the
tachycardia and improve symptom burden in patients with POTS.
METHODS:
In this protocol, patients with POTS (n=30) underwent acute drug trials with
DDAVP 0.2 mg orally and placebo, on separate mornings, in a randomized
crossover design. Blood pressure, HR and symptoms were assessed while seated
and after standing for up to 10 minutes prior to and hourly for 4 hours
following study drug.
RESULTS:
Standing HR was significantly lower following DDAVP compared to placebo
(101.9 ± 14.5 vs. 109.2 ± 17.4 bpm (P<0.001)). Standing blood pressure was
not affected (P=0.28). The symptom burden improved with DDAVP (from a score
of 18 ± 18 to 13 ± 15 arbitrary units [au] at 2 hours) compared with placebo
(from 18 ± 17 to 19 ± 16 au; P=0.010).
CONCLUSION:
Oral desmopressin significantly attenuated tachycardia and improved symptoms
in POTS. The safety profile of this approach would need to be examined
before it can be recommended for routine treatment of these patients.
Copyright © 2012. Published by Elsevier Inc.
PMID: 22561596 [PubMed - as supplied by publisher]
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