Exercise performance in adolescents with autonomic dysfunction
Abstract
Objective To test the hypothesis that excessive postural tachycardia is associated with deconditioning rather than merely being an independent sign of autonomic dysfunction in patients with postural orthostatic tachycardia syndrome (POTS).Study design We retrospectively analyzed records from 202 adolescents who underwent both head up-tilt and maximal exercise testing. Patients were classified as POTS if they had ≥ 30 min(-1) rise in heart rate (HR) after tilt-table test; and deconditioned if peak O(2) uptake was < 80% predicted. Changes in HR during exercise and recovery were compared between groups.Results Two-thirds of patients were deconditioned, irrespective of whether they fulfilled diagnostic criteria for POTS, but peak O(2) uptake among patients with POTS was similar to patients without POTS. HR was higher at rest and during exercise; whereas stroke volume was lower during exercise, and HR recovery was slower in patients with POTS compared with patients without POTS.Conclusions Most patients who presented with chronic symptoms of dizziness, fatigue, or pre-syncope, were deconditioned, but, because the proportion of deconditioned patients was similar in POTS vs non-POTS groups, we conclude that HR changes in POTS are not solely because of inactivity resulting in deconditioning.
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The reported prevalence of deconditioning in POTS varies widely, from 20% to 90% of patients, depending on recruitment site and exercise protocol.
“The true prevalence of deconditioning in POTS also remains unclear, with studies showing large variations ranging from 20 to 90% of patients depending on site of patient recruitment and exercise protocols (Parsaik et al., 2012;Burkhardt et al., 2011;Arnold et al., 2013).”
From Postural tachycardia syndrome – Diagnosis, physiology, and prognosis (2018) · cites this paper as Burkhardt et al., 2011
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- Authors
- Burkhardt, B. E. U., Fischer, P. R., Brands, C. K., Porter, C.-B. J., Weaver, A. L., Yim, P. J., & Pianosi, P. T.
- Affiliations
- University Medical Center Freiburg (DE)
- Mayo Clinic (US)
- Corresponding author
- Pianosi, Paolo T.
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 158
- Issue
- 1
- Pages
- 15-19.e1
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2069451394
- Cited by
- 31
- References
- 28
- Citations by year
- 2026: 1 · 2025: 4 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- postural orthostatic tachycardia syndrome, autonomic dysfunction, deconditioning, exercise performance, heart rate, adolescents, peak oxygen uptake, stroke volume, heart rate recovery, tilt table test, dizziness, presyncope
- MeSH terms
- Adolescent, Autonomic Nervous System Diseases, Female, Humans, Male, Retrospective Studies, Exercise, Tilt-Table Test, Postural Orthostatic Tachycardia Syndrome
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