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Cited by 61Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlCardiovascular and exercise physiology

Limb venous compliance in patients with idiopathic orthostatic intolerance and postural tachycardia

Freeman, Roy, Lirofonis, Vasilios, Farquhar, William B., Risk, Marcelo·2002·Journal of Applied Physiology
DOI 10.1152/japplphysiol.00817.2001
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Abstract

Venous denervation and increased venous pooling may contribute to symptoms of orthostatic intolerance. We examined venous compliance in the calf and forearm in 11 orthostatic-intolerant patients and 15 age-matched controls over a range of pressures, during basal conditions and sympathetic excitation. Occlusion cuffs placed around the upper arm and thigh were inflated to 60 mmHg and deflated to 10 mmHg over 1 min. Limb volume was measured continuously with a mercury-in-Silastic strain gauge. Compliance was calculated as the numerical derivative of the pressure-volume curve. The pressure-volume relationship in the upper and lower extremities in the basal and sympathetically activated state was significantly lower in the orthostatic-intolerant patients (all P < 0.05). Sympathoexcitation lowered the pressure-volume relationship in the lower extremity in patients ( P < 0.001) and controls ( P < 0.01). Venous compliance was significantly less in patients in the lower extremity in the basal state over a range of pressures ( P < 0.05). Venous compliance was less in patients compared with controls in the upper ( P < 0.005) and lower extremities ( P < 0.01) in the sympathetically activated state, but there were no differences at individual pressure levels. Sympathetic activation did not change venous compliance in the upper and lower extremity in patients and controls. Patients with orthostatic intolerance have reduced venous compliance in the lower extremity. Reduced compliance may limit the dynamic response to orthostatic change and thereby contribute to symptoms of orthostatic intolerance in this population group.

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Crossref · 10.1152/japplphysiol.00817.2001

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  • Acrocyanosis in POTS is not due to increased venous compliance but may be caused by decreased skin blood flow, possibly related to abnormal cutaneous nitric oxide activity.

    “This acrocyanosis in POTS is not due to increased venous compliance [22;23] but may be caused by a decrease in blood flow to the skin, possibly related to abnormal cutaneous nitric oxide activity [24].”

    From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [22]

  • A dark red-blue discoloration of the legs (acrocyanosis) occurs with standing in about 50% of POTS patients.

    “A dark red-blue discoloration of the legs might occur with standing, extending from the feet to above the knees in ∼50% of patients with POTS.”

    From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [22]

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Authors
Freeman, R., Lirofonis, V., Farquhar, W. B., & Risk, M.
Affiliations
Beth Israel Deaconess Medical Center (US)
ORCID
Venue
Journal of Applied Physiology
Publisher
American Physiological Society
Published
2002-08-01
Volume
93
Issue
2
Pages
636-644
ISSN
  • 0161-7567 (ISSN-L)
  • 8750-7587
  • 1522-1601
DOI
10.1152/japplphysiol.00817.2001
OpenAlex
W2172021984
Cited by
61
References
40
Citations by year
2026: 1 · 2025: 3 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 4
FWCI
5.08
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Applied Physiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5f32hl010211-03)
  • National Heart, Lung, and Blood Institute (R01-HL-59459, F32 HL-10211-02, R01HL059459)
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 › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
orthostatic intolerance, postural orthostatic tachycardia syndrome, venous compliance, venous pooling, pressure-volume relationship, sympathetic activation, lower limb veins, calf, forearm, orthostatic hypotension
MeSH terms
Adult, Blood Pressure, Blood Volume, Compliance, Female, Humans, Hypotension, Orthostatic, Male, Physical Fitness, Plethysmography, Posture, Sympathetic Nervous System, Tachycardia, Veins, Exercise

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