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Cited by 71Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlGastrointestinal motility and disorders

Splanchnic-mesenteric capacitance bed in the postural tachycardia syndrome (POTS)

Tani, Hiroshi, Singer, Wolfgang, McPhee, Benjamin R., Opfer-Gehrking, Tonette L., Haruma, Ken, Kajiyama, Goro, Low, Phillip A.·2000·Autonomic Neuroscience
DOI 10.1016/s1566-0702(00)00205-8
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Abstract

Background Gastroenterologic symptoms are common in the postural tachycardia syndrome (POTS), and postprandial worsening of orthostatic symptoms often occurs. We, therefore, investigated splanchnic-mesenteric vasoregulation in POTS. Subjects and methods Eleven patients with POTS (one man, 10 women, 29.4 +/- 7.7 (S.D.) years) and 10 controls (two men, eight women, 27.9 +/- 5.6 years) participated in this study. The protocol included 5 min of 70 degrees head-up tilt (HUT) before and after a liquid meal, as well as 1.5 min of hyperventilation. Blood pressure (BP), heart rate (HR), endtidal CO2, and cardiovascular indices derived from thoracic electrical bioimpedance were continuously monitored. Superior mesenteric artery (SMA) blood flow was measured by real time Doppler ultrasound and analyzed off-line. Cross-sectional area of SMA (SMA-area) and time-averaged velocity (SMA-TAV) were measured; SMA blood flow (SMA-BF) and vascular resistance (SMA-VR) were derived. Results The following significant results were found: at supine rest, the POTS group had higher HR, BP, SMA-TAV and SMA-BF and a lower SMA-VR than the control group. HUT resulted in a reduction of pulse pressure, CO2 level, SMA-area, SMA-TAV and SMA-VF and increment of HR and SMA-VR in both groups. The POTS group underwent greater increment of HR and greater reduction of CO2 than controls. Hyperventilation induced increment of HR and cardiac index (CI) and reduction of SMA-VR in controls; no significant change occurred…

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Crossref · 10.1016/s1566-0702(00)00205-8

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  • Partial autonomic neuropathy in POTS extends beyond the lower extremities into the pelvic and splanchnic circulation.

    “The extent of partial autonomic neuropathy extends beyond the lower extremities into the pelvic and splanchnic circulation.”

    From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [24]

  • Doppler ultrasound and plethysmography studies have demonstrated abnormally increased blood flow and pooling in the splanchnic and pelvic circulation of POTS patients both at rest and in an upright position.

    “Both Doppler ultrasound and plethysmography studies have demonstrated abnormally increased blood flow and pooling in the splanchnic and pelvic circulation of POTS patients both at rest and in an upright position (20-24).”

    From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [24]

  • POTS patients have increased resting mesenteric blood flow and reduced splanchnic vascular resistance despite normal systemic vascular resistance.

    “Tani et al. [64] reported an increase in resting mesenteric blood flow and reduced splanchnic vascular resistance in spite of normal systemic vascular resistance.”

    From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [64]

  • After a meal, POTS patients have a larger increase in mesenteric blood flow than controls, suggesting excessive splanchnic capacitance during resting conditions and possibly after a meal.

    “After a meal, POTS patients had a larger increase in mesenteric blood flow than in controls, and this suggests that they have excessive splanchnic capacitance during resting conditions and possibly after a meal.”

    From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [64]

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Authors
Tani, H., Singer, W., McPhee, B. R., Opfer-Gehrking, T. L., Haruma, K., Kajiyama, G., & Low, P. A.
Affiliations
  • Mayo Clinic (US)
  • Hiroshima University (JP)
Corresponding author
Low, Phillip A.
ORCID
Venue
Autonomic Neuroscience
Publisher
Elsevier BV
Published
2000-12
Volume
86
Issue
1-2
Pages
107-113
ISSN
1566-0702 (ISSN-L)
DOI
10.1016/s1566-0702(00)00205-8
OpenAlex
W2038817571
Cited by
71
References
33
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 2
FWCI
2.89
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Autonomic Neuroscience (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (1p01ns032352-01a1)
  • National Institute of Neurological Disorders and Stroke (P01 NS 32352)
  • National Center for Research Resources (M01-RR00 585, M01RR000585)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
postural orthostatic tachycardia syndrome, superior mesenteric artery blood flow, head-up tilt, hyperventilation, gastrointestinal symptoms, vascular resistance, impedance cardiography
MeSH terms
Adult, Eating, Female, Humans, Hyperventilation, Hypotension, Orthostatic, Male, Splanchnic Circulation, Tachycardia, Hypocapnia

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