Treatment of orthostatic tachycardia with erythropoietin
Abstract
Purpose To determine whether increasing red blood cell volume with erythropoietin reverses the hemodynamic response to standing in patients with orthostatic tachycardia.Patients and methods Eight patients (2 men, 6 women) with orthostatic tachycardia were administered erythropoietin (50 U/kg body weight 3 times a week for 6 to 12 weeks) in order to reverse their red blood cell volume deficit. Six of the patients also received fludrocortisone (0.1 mg/d). Plasma and red blood cell volumes as well as the hemodynamic response to orthostatic stress were measured before and after erythropoietin therapy.Results Erythropoietin therapy increased the mean +/- hematocrit from 37.6 +/- 1.0 to 46.4 +/- 1.4 (+/- standard error) (P < 0.01) and increased the red blood cell volume from 17.7 +/- 1.1 to 24.6 +/- 2.0 mL/kg (P < 0.01). Treatment increased supine mean blood pressure (from 87 +/- 4 to 93 +/- 5 mm Hg, P < 0.025) and standing mean blood pressure (from 87 +/- 4 to 94 +/- 5 mm Hg, P < 0.025). Erythropoietin therapy, however, failed to reverse orthostatic tachycardia. Following treatment, the mean heart rate after 5 minutes standing was 129 +/- 7 bpm, not significantly different from the pretreatment standing heart rate (134 +/- 5 bpm).Conclusions Although patients with the orthostatic tachycardia syndrome have a deficit in red blood cell volume, this is not the cause of their abnormal hemodynamic response to standing. Erythropoietin therapy fails to reverse orthostatic tachycardia.
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Erythropoietin does not appear to improve the orthostatic tachycardia of POTS.
“Erythropoietin does not appear to improve the orthostatic tachycardia of POTS (71, 72)”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [71]
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- Authors
- Hoeldtke, R. D., Horvath, G. G., & Bryner, K. D.
- Affiliations
- West Virginia University (US)
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1995-11
- Volume
- 99
- Issue
- 5
- Pages
- 525-529
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W1995274171
- Cited by
- 38
- References
- 19
- Citations by year
- 2024: 3 · 2022: 1 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 4 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (AM32339)
- National Center for Research Resources (RR-349)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- orthostatic tachycardia, erythropoietin, erythrocyte volume, hematocrit, fludrocortisone, orthostatic stress, blood pressure, heart rate
- MeSH terms
- Adult, Aged, Blood Volume, Erythropoietin, Female, Hematocrit, Hemodynamics, Humans, Male, Middle Aged, Posture, Tachycardia, Treatment Failure
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