Effect of a neck compression collar on cardiorespiratory and cerebrovascular function in postural orthostatic tachycardia syndrome (POTS)
Abstract
Postural orthostatic tachycardia syndrome (POTS) is accompanied by reduced brain blood flow, autonomic dysfunction, and orthostatic intolerance. We hypothesized that wearing a neck compression collar would attenuate orthostatic symptoms, increase brain blood flow, and influence autonomic reflexes. Ten participants with POTS (9 women, age: 36 ± 10) underwent two trials of supine rest, paced deep breathing (6 breaths/min), Valsalva maneuver (40 mmHg for 15 s), and 70° upright tilt. For one trial, participants wore a neck compression device (Q30 Innovations). Blood pressure, heart rate (HR), brain blood flow velocity, stroke volume, respiratory rate, and end-tidal gases were continuously measured. The Vanderbilt Orthostatic Symptom Score was compiled at the end of tilt. The use of the collar reduced the orthostatic symptom score of participants with POTS during upright tilt (26.9 ± 12.5 to 18.7 ± 13.1, P = 0.04). Collar compression in the supine condition reduced the low-frequency domain of HR variability (60 ± 18 to 51 ± 23 normalized units, P = 0.04) and increased the change in HR (15 ± 5 to 17 ± 6 bpm, P = 0.02) and E:I ratio (1.2 ± 0.1 to 1.3 ± 0.1, P = 0.01) during paced deep breathing. Throughout tilt, wearing the collar reduced respiratory rate (baseline: 13 ± 3 to 12 ± 4 breath/min; tilt: 18 ± 5 to 15 ± 5 breath/min; main effect of collar P = 0.048), end-tidal oxygen (baseline: 115 ± 5 to 112 ± 5 mmHg; tilt: 122 ± 10 to 118 ± 11 mmHg; main effect of collar P = 0.026). In…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
All three randomized experimental crossover trials of compression were associated with a significant treatment effect on symptom burden relative to comparison conditions.
“All three trials were associated with a significant treatment effect on symptom burden relative to the comparison conditions.”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Nardone et al., 2020
The trials of a neck compression collar (5 min) and abdominal and lower body compression (10 min) both improved symptom burden during head-up-tilt.
“both improved symptom burden during head-up-tilt.”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Nardone et al., 2020
Cites
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0119-5 · Cited by 1,697 · see citing works
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013 · cited 2× · see citing works
“…tachycardia syndrome (POTS), a condition defined by an exaggerated heart rate response during orthostasis ( (cid:4) 120 bpm during upright tilt or an increase of 30 bpm within 10 min of upright tilt) (7, 23), suffer from chronic orthostatic intolerance leading to reduced quality of life (2).”
Postural tachycardia syndrome (POTS)
LOW, P. A., SANDRONI, P., JOYNER, M., & SHEN, W. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01407.x · Cited by 358 · see citing works
Cardiac origins of the postural orthostatic tachycardia syndrome
Fu, Q., VanGundy, T. B., Galbreath, M. M., Shibata, S., Jain, M., Hastings, J. L., Bhella, P. S., & Levine, B. D. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.043 · Cited by 329 · see citing works
Acetylcholinesterase inhibition improves tachycardia in postural tachycardia syndrome
Raj, S. R., Black, B. K., Biaggioni, I., Harris, P. A., & Robertson, D. (2005) · Circulation · doi:10.1161/circulationaha.104.497594 · Cited by 171 · see citing works
Jacob, G., Shannon, J. R., Costa, F., Furlan, R., Biaggioni, I., Mosqueda-Garcia, R., Robertson, R. M., & Robertson, D. (1999) · Circulation · doi:10.1161/01.cir.99.13.1706 · Cited by 117 · see citing works
Anderson, J. W., Lambert, E. A., Sari, C. I., Dawood, T., Esler, M. D., Vaddadi, G., & Lambert, G. W. (2014) · Frontiers in Physiology · doi:10.3389/fphys.2014.00230 · Cited by 96 · see citing works
Baroreflex control of muscle sympathetic nerve activity in postural orthostatic tachycardia syndrome
Muenter Swift, N., Charkoudian, N., Dotson, R. M., Suarez, G. A., & Low, P. A. (2005) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.01243.2004 · Cited by 70 · see citing works
Stewart, J. M., Pianosi, P., Shaban, M. A., Terilli, C., Svistunova, M., Visintainer, P., & Medow, M. S. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008854 · Cited by 55 · see citing works
Altered oscillatory cerebral blood flow velocity and autoregulation in postural tachycardia syndrome
Medow, M. S., Del Pozzi, A. T., Messer, Z. R., Terilli, C., & Stewart, J. M. (2014) · Frontiers in Physiology · doi:10.3389/fphys.2014.00234 · Cited by 23 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Knoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21 · see citing works
- Authors
- Nardone, M., Guzman, J., Harvey, P. J., Floras, J. S., & Edgell, H.
- Affiliations
- York University (CA)
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- University of Toronto (CA)
- Mount Sinai Hospital (CA)
- Corresponding author
- Edgell, Heather
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 2020-04-01
- Volume
- 128
- Issue
- 4
- Pages
- 907-913
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- OpenAlex
- W3010671013
- Cited by
- 8
- References
- 10
- Citations by year
- 2025: 4 · 2024: 2 · 2022: 1 · 2021: 1
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Standing up to POTS
- Q30 Innovations
- 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 › Neurology › Long-Term Effects of COVID-19
- Keywords
- orthostatic intolerance, cerebral blood flow, autonomic dysfunction, heart rate variability, respiratory rate, Valsalva maneuver, upright tilt, orthostatic symptoms, cerebrovascular function, cardiopulmonary function, end-tidal oxygen, autonomic reflexes
- MeSH terms
- Adult, Blood Pressure, Female, Heart Rate, Humans, Middle Aged, Tachycardia, Valsalva Maneuver, Tilt-Table Test, Postural Orthostatic Tachycardia Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
