Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome
Abstract
Background— Patients with postural tachycardia syndrome (POTS) experience considerable disability, but in most, the pathophysiology remains obscure. Plasma volume disturbances have been implicated in some patients. We prospectively tested the hypothesis that patients with POTS are hypovolemic compared with healthy controls and explored the role of plasma renin activity and aldosterone in the regulation of plasma volume. Methods and Results— Patients with POTS (n=15) and healthy controls (n=14) underwent investigation. Heart rate (HR), blood pressure (BP), plasma renin activity, and aldosterone were measured with patients both supine and upright. Blood volumes were measured with 131 I-labeled albumin and hematocrit. Patients with POTS had a higher orthostatic increase in HR than controls (51±18 versus 16±10 bpm, P <0.001). Patients with POTS had a greater deficit in plasma volume (334±187 versus 10±250 mL, P <0.001), red blood cell volume (356±128 versus 218±140 mL, P =0.010), and total blood volume (689±270 versus 228±353 mL, P <0.001) than controls. Despite the lower plasma volume in patients with POTS, there was not a compensatory increase in plasma renin activity (0.79±0.58 versus 0.79±0.74 ng · mL −1 · h −1 , P =0.996). There was a paradoxically low level of aldosterone in the patients with POTS (190±140 pmol/L versus 380±230 pmol/L; P =0.017). Conclusions— Patients with POTS have paradoxically unchanged plasma renin activity and low aldosterone given their marked reduction in plasma volume. These patients also have a significant red blood cell volume deficit, which is regulated by the renal hormone erythropoietin. These abnormalities suggest that the kidney may play a key role in the pathophysiology of POTS.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Patients with POTS have paradoxically low aldosterone levels, inappropriately low plasma renin activity, and elevated concentrations of circulating angiotensin II despite low blood volume.
“Despite their low blood volume, patients with POTS were found to have paradoxically low aldosterone levels and inappropriately low plasma renin activity, while having elevated concentrations of circulating angiotensin II [12,25].”
From Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome (2012) · cites this paper as [12]
The Renin-Aldosterone Paradox section supports low aldosterone and renin activity that was inappropriately low for the patients’ hypovolemia. But it proposes inappropriately low—not elevated—angiotensin II as the most likely explanation. The Study Limitations section adds that angiotensin II was not measured directly. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredSome POTS patients have lower plasma renin activity and aldosterone levels than healthy subjects.
“Paradoxically, some of these patients have low plasma renin activity and aldosterone levels compared with healthy subjects.32”
From 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope (2015) · cites this paper as [32]
The Renin and Aldosterone results report significantly lower aldosterone in patients with POTS than in healthy controls, both supine and upright. They report no difference in plasma renin activity in either position. The paper calls renin inappropriately low relative to the patients’ reduced plasma volume, not lower than the controls’ renin activity. (LLM, conf=0.94)
Experimental — accuracy not yet measuredAdvising patients with POTS to drink 3 L of water per day and to maximize dietary salt intake can promote sodium retention and blood volume expansion.
“The findings of a small 2005 case–control intervention study suggest that advising patients to drink 3 L of water per day and to maximize their dietary salt intake can promote sodium retention and blood volume expansion.28”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [28]
The Plasma Volume section says sodium intake can alter plasma volume, and the Conclusions describe salt and water retention as increasing plasma volume under normal circumstances. But the Protocol used a fixed sodium diet, not an intervention advising patients with POTS to drink 3 L of water daily and maximize salt intake. The paper does not establish that the proposed advice promotes sodium retention or blood volume expansion in those patients. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMany patients with POTS have low blood volume.
“We and others have found that many patients with POTS have low blood volume [12,24].”
From Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome (2012) · cites this paper as [12]
Features described in subgroups of POTS patients include increased sympathetic nervous system tone (hyperadrenergic POTS), partial peripheral sympathetic denervation leading to relative central hypovolemia (neuropathic POTS), and low blood volume (absolute hypovolemia), which may drive some other hemodynamic findings.
“Features described in subgroups of patients include increased sympathetic nervous system tone (i.e., hyperadrenergic POTS),17 partial peripheral sympathetic denervation leading to relative central hypovolemia (i.e., neuropathic POTS)27 and low blood volume (i.e., absolute hypovolemia),28 which may drive some of the other hemodynamic findings.”
From Diagnosis and management of postural orthostatic tachycardia syndrome (2022) · cites this paper as [28]
A perturbed renin-angiotensin-aldosterone axis leading to low blood volume is a potential mechanism that contributes to POTS pathophysiology.
“These studies strongly implicate a perturbed RAAS axis leading to low blood volume as a potential mechanism that contributes to POTS pathophysiology.”
From Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome (2012) · cites this paper as [12]
More commonly proposed causes of POTS include partial peripheral neuropathy, a deficit in blood volume, abnormalities in the renin-angiotensin-aldosterone system, physical deconditioning, autoantibodies targeting peripheral adrenergic receptors, and a hyperadrenergic state resulting from central activation of the sympathetic nervous system.
“More commonly proposed causes include partial peripheral neuropathy (“neuropathic POTS”),19 a deficit in blood volume, abnormalities in the renin-angiotensin-aldosterone system (RAAS)20, physical deconditioning,10 autoantibodies targeting peripheral adrenergic receptors21 and a hyperadrenergic state resulting from central activation of the sympathetic nervous system (“HyperPOTS”).”
From Hyperadrenergic Postural Tachycardia Syndrome: Clinical Biomarkers and Response to Guanfacine (2024) · cites this paper as [20]
POTS patients have impaired ability of the renin-angiotensin aldosterone system to expand blood volume.
“While circulating angiotensin II levels are high, POTS patients have impaired ability of the RAAS to expand blood volume (Li et al., 2015a; Mustafa et al., 2011; Raj et al., 2005; Stewart et al., 2006b).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Raj et al., 2005
Absolute hypovolemia is commonly observed in POTS, with up to 70% of patients exhibiting deficits in plasma volume and red blood cell volume.
“Absolute hypovolemia is commonly observed in POTS, with up to 70% of patients exhibiting deficits in plasma volume and red blood cell volume (Fu et al., 2010; Raj et al., 2005; Sheldon et al., 2015; Stewart et al., 2006a).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Raj et al., 2005
Many POTS patients have a blood volume lower than expected for their size and sex, suggesting that hypovolemia may underlie some of the hemodynamic findings of POTS.
“Many POTS patients have a blood volume that is lower than expected for their size and sex, suggesting that hypovolemia may underlie some of the hemodynamic findings of POTS (Fu et al., 2010; Mar and Raj, 2014; Raj et al., 2005).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Raj et al., 2005
Some POTS patients with hypovolemia have inappropriately low standing plasma renin activity and aldosterone compared with normovolemic controls.
“Some POTS patients with hypovolemia, however, have inappropriately low standing plasma renin activity and aldosterone compared with normovolemic controls [46;12].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [46]
One of the more consistent findings in POTS is a deficit in total blood, plasma, and red cell volume.
“One of the more consistent findings in patients with POTS is a deficit in total blood, plasma and red cell volume [45;13;46].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [46]
The aldosterone:renin ratio is lower in POTS patients than in healthy control subjects.
“Additionally, the aldosterone:renin ratio was found to be lower in POTS patients than in healthy control subjects (34).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Some POTS patients have 13-22% less plasma or blood volume than healthy controls.
“Studies have shown that some POTS patients have 13-22% less plasma or blood volume than do healthy controls (33-35).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
A significant portion of POTS patients suffer from a state of persistent hypovolemia.
“A significant portion of POTS patients suffer from a state of persistent hypovolemia.”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Despite low blood and plasma volumes, plasma renin activity and aldosterone levels are inappropriately low in POTS patients.
“Despite these low blood and plasma volumes, plasma renin activity and aldosterone levels are also inappropriately low in POTS patients.”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Supine levels of norepinephrine are similar between healthy controls and POTS patients.
“Supine levels of norepinephrine are similar between healthy controls and POTS patients (34).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Hyperadrenergic POTS is an important endophenotype of POTS with the characteristic neurohormonal hallmark of elevated upright plasma norepinephrine.
“Hyperadrenergic POTS is an important endophenotype of POTS with the characteristic, neurohormonal hallmark of elevated upright plasma norepinephrine (34, 36).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Levels of plasma epinephrine appear to be similar between POTS patients and healthy subjects.
“Levels of plasma epinephrine appear to be similar between POTS patients and healthy subjects (34, 36).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [34]
Low blood volume or hypovolemia is a common finding in POTS, with many patients reported to have deficits in red cell and plasma volume.
“Low blood volume or hypovolemia is a common finding in POTS, with many patients reported to have deficits in red cell and plasma volume”
From Postural tachycardia syndrome – Diagnosis, physiology, and prognosis (2018) · cites this paper as Raj et al., 2005
Circulating angiotensin II levels are approximately 2-fold higher in POTS, perhaps due to reduced levels or activity of its degrading enzyme ACE2.
“Circulating angiotensin II levels are approximately 2-fold higher in POTS, perhaps due to reduced levels or activity of its degrading enzyme ACE2”
From Postural tachycardia syndrome – Diagnosis, physiology, and prognosis (2018) · cites this paper as Raj et al., 2005
POTS patients appear to have a renin-aldosterone paradox in response to both hypovolemia and orthostatic challenge.
“POTS patients appear to have a “renin-aldosterone paradox” in response to both hypovolemia and orthostatic challenge.”
From Postural tachycardia syndrome – Diagnosis, physiology, and prognosis (2018) · cites this paper as Raj et al., 2005
In these hypovolaemic patients, the POTS phenotype might be caused by neuroendocrine and renal dysfunction leading to chronic intravascular fluid deficiency.
“In these patients, POTS phenotype might be caused by neuroendocrine and renal dysfunction leading to chronic intravascular fluid deficiency.”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [54]
A subset of POTS patients show relative hypovolaemia and impaired renin-angiotensin-aldosterone regulation.
“Further, a subset of POTS patients demonstrate relative hypovolaemia and impaired renin-angiotensin-aldosterone regulation [54].”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [54]
Many POTS patients have decreased plasma volume.
“Many POTS patients have a decreased plasma volume (6–8) and high standing plasma norepinephrine (9).”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [6]
A plasma volume deficit should stimulate the renin-angiotensin-aldosterone system to promote sodium retention, but this regulatory link might be defective in POTS.
“Although a plasma volume deficit should stimulate the renin–angiotensin–aldosterone system to promote sodium retention, this regulatory link might be defective in POTS (6).”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [6]
Studies that reported a plasma volume deficit in POTS patients despite a normal- to high-sodium diet suggest that patients may not effectively respond to dietary sodium with plasma volume expansion.
“Studies that reported a plasma volume deficit in POTS patients despite a normal- to high-sodium diet (≥150 mEq sodium/day) (6, 14, 15), suggest that patients may not effectively respond to dietary sodium with plasma volume expansion.”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [6]
Plasma volume was determined by the indicator tracer-dilution technique using the DAXOR BVA-100 Blood Volume Analyzer system.
“Plasma volume (PV) was determined by the indicator tracer-dilution technique, using the DAXOR BVA-100 Blood Volume Analyzer system (6) (DAXOR Corporation), on Day 7.”
From Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome (2021) · cites this paper as [6]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Introduction to Statistical Analysis.
Latshaw, V. V., Dixon, W. J., & Massey, F. J. (1957) · American Mathematical Monthly · doi:10.2307/2309989 · Cited by 5,083 · see citing works
Hypertension : pathophysiology, diagnosis, and management
Laragh, J. H., & Brenner, B. M. (1995) · Raven Press eBooks · Cited by 1,935 · see citing works
Rowell, L. B. (1993) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199312000-00021 · Cited by 1,093 · see citing works
Orthostatic Intolerance and Tachycardia Associated with Norepinephrine-Transporter Deficiency
Shannon, J. R., Flattem, N. L., Jordan, J., Jacob, G., Black, B. K., Biaggioni, I., Blakely, R. D., & Robertson, D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200002243420803 · Cited by 594 · cited 1× · see citing works
“(2) have a significantly lower level of serum aldosterone, (3)”
BackgroundSelf-citationIdiopathic postural orthostatic tachycardia syndrome: An attenuated form of acute pandysautonomia?
Schondorf, R., & Low, P. A. (1993) · Neurology · doi:10.1212/wnl.43.1_part_1.132 · Cited by 548 · see citing works
Control of aldosterone secretion: a model for convergence in cellular signaling pathways
SPÄT, A., & HUNYADY, L. (2004) · Physiological Reviews · doi:10.1152/physrev.00030.2003 · Cited by 494 · see citing works
Sawka, M. N., Convertino, V. A., Eichner, E. R., SCHNIEDER, S. M., & Young, A. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200002000-00012 · Cited by 445 · see citing works
Rowell, L. B. (1993) · doi:10.1093/oso/9780195073621.001.0001 · Cited by 443 · see citing works
THE BODY/VENOUS HEMATOCRIT RATIO: ITS CONSTANCY OVER A WIDE HEMATOCRIT RANGE
Chaplin, H., Mollison, P. L., & Vetter, H. O. (1953) · Journal of Clinical Investigation · doi:10.1172/jci102859 · Cited by 395 · see citing works
Prediction of the normal blood volume. Relation of blood volume to body habitus.
Feldschuh, J., & Enson, Y. (1977) · Circulation · doi:10.1161/01.cir.56.4.605 · Cited by 315 · see citing works
Postural tachycardia syndrome (POTS)
Lamotte, G., & Low, P. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85492-4.00118-6 · Cited by 300 · see citing works
Pharmacologic distinction of different orthostatic hypotension syndromes
Polinsky, R. J., Kopin, I. J., Ebert, M. H., & Weise, V. K. (1981) · Neurology · doi:10.1212/wnl.31.1.1 · Cited by 295 · see citing works
The epidemic of orthostatic tachycardia and orthostatic intolerance
Robertson, D. (1999) · The American Journal of the Medical Sciences · doi:10.1016/s0002-9629(15)40480-x · Cited by 293 · see citing works
Self-citationCorrection for Plasma Trapped in the Red Cell Column of the Hematocrit
Chaplin, H., & Mollison, P. L. (1952) · Blood · doi:10.1182/blood.v7.12.1227.1227 · Cited by 285 · see citing works
Angiotensin II: a powerful controller of sodium transport in the early proximal tubule.
Cogan, M. G. (1990) · Hypertension · doi:10.1161/01.hyp.15.5.451 · Cited by 249 · see citing works
Jackson, E. (1995) · Medical Entomology and Zoology · Cited by 218 · see citing works
Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia
Jacob, G., Shannon, J. R., Black, B., Biaggioni, I., Mosqueda-Garcia, R., Robertson, R. M., & Robertson, D. (1997) · Circulation · doi:10.1161/01.cir.96.2.575 · Cited by 206 · see citing works
Self-citationErythropoietin titers in anemic, nonuremic patients.
Erslev, A. J., Wilson, J., & Caro, J. (1987) · PubMed · Cited by 193 · see citing works
The mechanism of action of erythropoietin
Spivak, J. L. (1986) · The International Journal Of Cell Cloning · doi:10.1002/stem.5530040302 · Cited by 185 · see citing works
Streeten, D. H. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114878 · Cited by 170 · see citing works
Vlahakos, D., Marathias, K. P., Agroyannis, B. J., & Madias, N. E. (2003) · Kidney International · doi:10.1046/j.1523-1755.2003.00850.x · Cited by 165 · see citing works
Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system
Jacob, G., Robertson, D., Mosqueda-Garcia, R., Ertl, A. C., Robertson, R. M., & Biaggioni, I. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00133-2 · Cited by 164 · see citing works
Self-citationFOUAD, F. M., TADENA-THOME, L., BRAVO, E. L., & TARAZI, R. C. (1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-104-3-298 · Cited by 154 · see citing works
Brunjes, S., Johns, V. J., & Crane, M. G. (1960) · New England Journal of Medicine · doi:10.1056/nejm196002252620805 · Cited by 142 · see citing works
Streeten, D. H. P., Thomas, D. F., & Bell, D. S. (2000) · The American Journal of the Medical Sciences · doi:10.1016/s0002-9629(15)40790-6 · Cited by 138 · see citing works
Stewart, J. M. (2002) · Circulation · doi:10.1161/01.cir.0000016348.55378.c4 · Cited by 138 · see citing works
Neurohormonal control of plasma volume.
Oh, G., & Jp, H. (1976) · PubMed · Cited by 133 · see citing works
Enalapril-Associated Anemia in Renal Transplant Recipients Treated for Hypertension
Vlahakos, D., Canzanello, V. J., Madaio, M. P., & Madias, N. E. (1991) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(12)81129-2 · Cited by 124 · see citing works
The Postural Orthostatic Tachycardia Syndrome:
Kanjwal, Y., KOSINSKI, D. J., & Grubb, B. P. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.t01-1-00262.x · Cited by 103 · see citing works
Marathias, K. P., Agroyannis, B. J., Mavromoustakos, T., Matsoukas, J., & Vlahakos, D. (2004) · Current Topics in Medicinal Chemistry · doi:10.2174/1568026043451311 · Cited by 86 · see citing works
HOELDTKE, R. D., & DAVIS, K. M. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-73-1-132 · Cited by 85 · see citing works
Angiotensin II increases erythropoietin production in healthy human volunteers
Freudenthaler, Schreeb, Körner, & Gleiter (1999) · European Journal of Clinical Investigation · doi:10.1046/j.1365-2362.1999.00530.x · Cited by 78 · see citing works
Streeten, D. H. P., Thomas, D., & Bell, D. S. (2000) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200007000-00001 · Cited by 75 · see citing works
Orthostatic Disorders of the Circulation
Streeten, D. H. P. (1987) · Springer eBooks · doi:10.1007/978-1-4684-8962-0 · Cited by 70 · see citing works
Renin-angiotensin system stimulates erythropoietin secretion in chronic hemodialysis patients.
Vlahakos, D., Balodimos, C., Papachristopoulos, V., Vassilakos, P. J., Hinari, E., & Vlachojannis, J. G. (1995) · PubMed · Cited by 58 · see citing works
Circulating levels of angiotensin I measured by radioimmunoassay in hypertensive subjects.
Workman, R. J., Sussman, C., Burkitt, D. W., & Liddle, G. W. (1979) · PubMed · Cited by 52 · see citing works
Why is Erythropoietin Made in the Kidney?
Donnelly, S. M. (2003) · Advances in experimental medicine and biology · doi:10.1007/978-1-4419-8997-0_6 · Cited by 46 · see citing works
(2012) · SpringerReference · doi:10.1007/springerreference_109856 · Cited by 42 · see citing works
Treatment of orthostatic tachycardia with erythropoietin
Hoeldtke, R. D., Horvath, G. G., & Bryner, K. D. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80230-7 · Cited by 38 · see citing works
LUNDVALL, J., & Bjerkhoel, P. (1995) · Acta Physiologica Scandinavica · doi:10.1111/j.1748-1716.1995.tb09895.x · Cited by 34 · see citing works
The Blood Volume in Pheochromocytoma Patients before and during Treatment with Phenoxybenzamine
Stenström, G., & Kutti, J. (1985) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1985.tb08862.x · Cited by 14 · see citing works
the use of blood volume determination in patients undergoing surgery for pheochromocytoma
SCKNELLE, N., Ferris, D. O., & SCHIRGER, A. (1964) · Anesthesia & Analgesia · doi:10.1213/00000539-196411000-00007 · Cited by 13 · see citing works
Losartan may modulate erythropoietin production
Donnelly, S. M., & Miller, J. (2001) · Journal of the Renin-Angiotensin-Aldosterone System · doi:10.3317/jraas.2001.040 · Cited by 13 · see citing works
Takaya, J., Matsusaka, T., Katori, H., Tamura, M., Miyazaki, Y., Homma, T., & Ichikawa, I. (2001) · Molecular Endocrinology · doi:10.1210/mend.15.12.0737 · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [9]9. Fouad FM, Tadena-Thome L, Bravo EL, Tarazi RC. Idiopathic hypo- volemia. Ann Intern Med. 1986;104:298 -303.
Cited by
Sorted by citations
Diabetic cardiovascular autonomic neuropathy
Vinik, A. I., & Ziegler, D. (2007) · Circulation · doi:10.1161/circulationaha.106.634949 · Cited by 1,255 · see citing works
Brugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomström‐Lundqvist, C., Calkins, H. G., Corrado, D., Deftereos, S. G., Diller, G., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz467 · Cited by 1,278 · 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 · see citing works
“Paradoxically, some of these patients have low plasma renin activity and aldosterone levels compared with healthy subjects.(32) This is a low-flow subtype with inappropriately high angiotensin II levels.”
BackgroundSelf-citationPostural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352 · 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
Postural Tachycardia Syndrome (POTS)
Raj, S. R. (2013) · Circulation · doi:10.1161/circulationaha.112.144501 · Cited by 320 · see citing works
Self-citationVernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304 · see citing works
Self-citationMitchell, A. M., Jones, A. E., Tumlin, J. A., & Kline, J. A. (2009) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.05200709 · Cited by 294 · see citing works
Autoimmune Basis for Postural Tachycardia Syndrome
Li, H., Yu, X., Liles, C., Khan, M., Vanderlinde‐Wood, M., Galloway, A., Zillner, C., Benbrook, A., Reim, S., Collier, D., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.113.000755 · Cited by 255 · see citing works
Self-citationPostural tachycardia syndrome—current experience and concepts
Mathias, C. J., Low, D. A., Iodice, V., Owens, A. P., Kirbis, M., & Grahame, R. (2012) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.187 · Cited by 251 · see citing works
Raj, S. R., Black, B. K., Biaggioni, I., Paranjape, S. Y., Ramirez, M., Dupont, W. D., & Robertson, D. (2009) · Circulation · doi:10.1161/circulationaha.108.846501 · Cited by 225 · see citing works
Self-citationRaj, S. R., Guzman, J. C., Harvey, P., Richer, L., Schondorf, R., Seifer, C., Thibodeau-Jarry, N., & Sheldon, R. S. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2019.12.024 · Cited by 223 · see citing works
Self-citationPediatric Disorders of Orthostatic Intolerance
Stewart, J. M., Boris, J. R., Chelimsky, G., Fischer, P. R., Fortunato, J. E., Grubb, B. P., Heyer, G. L., Jarjour, I. T., Medow, M. S., Numan, M. T., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-1673 · Cited by 222 · see citing works
(2006) · PubMed · Cited by 190 · see citing works
Self-citationPostural tachycardia syndrome – Diagnosis, physiology, and prognosis
Arnold, A. C., Ng, J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.02.005 · Cited by 186 · see citing works
Self-citationFu, Q., VanGundy, T. B., Shibata, S., Auchus, R. J., Williams, G. H., & Levine, B. D. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.172262 · Cited by 175 · see citing works
Exercise and non-pharmacological treatment of POTS
Fu, Q., & Levine, B. D. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.07.001 · Cited by 174 · 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
Self-citationThe hemodynamic and neurohumoral phenotype of postural tachycardia syndrome
Garland, E. M., Raj, S. R., Black, B. K., Harris, P. A., & Robertson, D. (2007) · Neurology · doi:10.1212/01.wnl.0000267663.05398.40 · Cited by 159 · see citing works
Self-citationCaught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome
Ocon, A. J. (2013) · Frontiers in Physiology · doi:10.3389/fphys.2013.00063 · Cited by 162 · see citing works
Postural tachycardia syndrome: beyond orthostatic intolerance
Garland, E. M., Celedonio, J. E., & Raj, S. R. (2015) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-015-0583-8 · Cited by 160 · see citing works
Self-citationSleep Disturbances and Diminished Quality of Life in Postural Tachycardia Syndrome
Bagai, K., Song, Y., Ling, J. F., Malow, B., Black, B. K., Biaggioni, I., Robertson, D., & Raj, S. R. (2011) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.28110 · Cited by 134 · see citing works
Self-citationPsychiatric profile and attention deficits in postural tachycardia syndrome
Raj, V, Haman, K. L., Raj, S. R., Byrne, D., Blakely, R. D., Biaggioni, I., Robertson, D., & Shelton, R. C. (2009) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2008.144360 · Cited by 131 · see citing works
Self-citationGeorge, S. A., Bivens, T. B., Howden, E. J., Saleem, Y., Galbreath, M. M., Hendrickson, D., Fu, Q., & Levine, B. D. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2015.12.012 · Cited by 127 · see citing works
Kucharik, A. H., & Chang, C. (2020) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-019-08755-8 · Cited by 122 · see citing works
Taub, P. R., Zadourian, A., Lo, H. C., Ormiston, C. K., Golshan, S., & Hsu, J. C. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.12.029 · Cited by 122 · see citing works
Postural orthostatic tachycardia syndrome: mechanisms and new therapies
Mar, P. L., & Raj, S. R. (2020) · Annual Review of Medicine · doi:10.1146/annurev-med-041818-011630 · Cited by 122 · see citing works
Self-citationMechanisms of sympathetic regulation in orthostatic intolerance
Stewart, J. M. (2012) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00266.2012 · Cited by 118 · see citing works
Adolescent Fatigue, POTS, and Recovery: A Guide for Clinicians
Kizilbash, S. J., Ahrens, S. P., Bruce, B. K., Chelimsky, G., Driscoll, S. W., Harbeck-Weber, C., Lloyd, R. M., Mack, K. J., Nelson, D. E., Ninis, N., et al. (2014) · Current Problems in Pediatric and Adolescent Health Care · doi:10.1016/j.cppeds.2013.12.014 · Cited by 120 · see citing works
Renal Impairment of Pure Autonomic Failure
Garland, E. M., Gamboa, A. C., Okamoto, L. E., Raj, S. R., Black, B. K., Davis, T. L., Biaggioni, I., & Robertson, D. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.136853 · Cited by 112 · see citing works
Self-citationShibata, S., Fu, Q., Bivens, T. B., Hastings, J. L., Wang, W., & Levine, B. D. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2012.233858 · Cited by 109 · see citing works
Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment
Olshansky, B., Cannom, D. S., Fedorowski, A., Stewart, J. M., Gibbons, C. H., Sutton, R., Shen, W.-K., Muldowney, J. A. S., Chung, T., Feigofsky, S., et al. (2020) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2020.03.010 · Cited by 102 · see citing works
Persistent splanchnic hyperemia during upright tilt in postural tachycardia syndrome
Stewart, J. M., Medow, M. S., Glover, J. L., & Montgomery, L. D. (2006) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00784.2005 · Cited by 95 · see citing works
Lambert, E., Eikelis, N., Esler, M., Dawood, T., Schlaich, M., Bayles, R., Socratous, F., Agrotis, A., Jennings, G., Lambert, G., et al. (2008) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.107.750471 · Cited by 94 · see citing works
Diagnosis and management of postural orthostatic tachycardia syndrome
Raj, S. R., Fedorowski, A., & Sheldon, R. S. (2022) · Canadian Medical Association Journal · doi:10.1503/cmaj.211373 · Cited by 95 · see citing works
Self-citationMasuki, S., Eisenach, J. H., Johnson, C. P., Dietz, N. M., Benrud-Larson, L. M., Schrage, W. G., Curry, T. B., Sandroni, P., Low, P. A., & Joyner, M. J. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00927.2006 · Cited by 91 · see citing works
Pharmacotherapy for postural tachycardia syndrome
Miller, A. J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.04.008 · Cited by 91 · see citing works
Self-citationPostural Orthostatic Tachycardia Syndrome: Prevalence, Pathophysiology, and Management
Zadourian, A., Doherty, T. A., Swiatkiewicz, I., & Taub, P. R. (2018) · Drugs · doi:10.1007/s40265-018-0931-5 · Cited by 90 · see citing works
Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes
Okamoto, L. E., Raj, S. R., Peltier, A., Gamboa, A., Shibao, C., Diedrich, A., Black, B. K., Robertson, D., & Biaggioni, I. (2012) · Clinical Science · doi:10.1042/cs20110200 · Cited by 89 · see citing works
Self-citationCoffin, S. T., Black, B. K., Biaggioni, I., Paranjape, S. Y., Orozco, C., Black, P. W., Dupont, W. D., Robertson, D., & Raj, S. R. (2012) · Heart Rhythm · doi:10.1016/j.hrthm.2012.05.002 · Cited by 88 · see citing works
Self-citationDisorders of the Autonomic Nervous System
Chelimsky, T. C., Robertson, D. M., & Chelimsky, G. G. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0434-1.00102-x · Cited by 87 · see citing works
Self-citationBlood Volume Analysis: A New Technique and New Clinical Interest Reinvigorate a Classic Study
Manzone, T., Dam, H. Q., Soltis, P. S., & SAGAR, V. V. (2007) · Journal of Nuclear Medicine Technology · doi:10.2967/jnmt.106.035972 · Cited by 85 · see citing works
A prospective, 1-year follow-up study of postural tachycardia syndrome
Kimpinski, K., Figueroa, J. J., Singer, W., Sletten, D. M., Iodice, V., Sandroni, P., Fischer, P. R., Opfer-Gehrking, T. L., Gehrking, J. A., & Low, P. A. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2012.02.020 · Cited by 81 · see citing works
Blood Volume Perturbations in the Postural Tachycardia Syndrome
Raj, S. R., & Robertson, D. (2007) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318063c6c0 · Cited by 80 · see citing works
Self-citationStewart, J. M., Glover, J. L., & Medow, M. S. (2006) · Clinical Science · doi:10.1042/cs20050254 · Cited by 77 · see citing works
A review of postural orthostatic tachycardia syndrome
Carew, S., ́Connor, M. O., Cooke, J., Conway, R. P., Sheehy, C. M., Costelloe, Á., & Lyons, D. (2008) · EP Europace · doi:10.1093/europace/eun324 · Cited by 73 · see citing works
Sodium Paradoxically Reduces the Gastropressor Response in Patients With Orthostatic Hypotension
Raj, S. R., Biaggioni, I., Black, B. K., Rali, A. S., Jordan, J., Taneja, I., Harris, P. A., & Robertson, D. (2006) · Hypertension · doi:10.1161/01.hyp.0000229906.27330.4f · Cited by 71 · see citing works
Self-citationCutaneous neuronal nitric oxide is specifically decreased in postural tachycardia syndrome
Stewart, J. M., Medow, M. S., Minson, C. T., & Taneja, I. (2007) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00600.2007 · Cited by 68 · see citing works
Postural tachycardia syndrome: current perspectives
Wells, R. M., Spurrier, A. J., Linz, D., Gallagher, C., Mahajan, R., Sanders, P., Page, A. J., & Lau, D. H. (2017) · Vascular Health and Risk Management · doi:10.2147/vhrm.s127393 · Cited by 69 · see citing works
Twenty-four-hour urinary sodium excretion and postural orthostatic tachycardia syndrome
Zhang, Q., Liao, Y., Tang, C., Du, J., & Jin, H. (2012) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2012.01.054 · Cited by 66 · see citing works
Reduced stroke volume during exercise in postural tachycardia syndrome
Masuki, S., Eisenach, J. H., Schrage, W. G., Johnson, C. P., Dietz, N. M., Wilkins, B. W., Sandroni, P., Low, P. A., & Joyner, M. J. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00175.2007 · Cited by 68 · see citing works
Raj, S. R., Bourne, K. M., Stiles, L. E., Miglis, M. G., Cortez, M. M., Miller, A. J., Freeman, R. L., Biaggioni, I., Rowe, P. C., Sheldon, R. S., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102836 · Cited by 63 · see citing works
Self-citationAbnormalities of angiotensin regulation in postural tachycardia syndrome
Mustafa, H. I., Garland, E. M., Biaggioni, I., Black, B. K., Dupont, W. D., Robertson, D., & Raj, S. R. (2011) · Heart Rhythm · doi:10.1016/j.hrthm.2010.11.009 · Cited by 62 · see citing works
Self-citationFu, Q., VanGundy, T. B., Shibata, S., Auchus, R. J., Williams, G. H., & Levine, B. D. (2010) · Hypertension · doi:10.1161/hypertensionaha.110.151787 · Cited by 62 · see citing works
Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome
Garland, E. M., Gamboa, A., Nwazue, V. C., Celedonio, J. E., Paranjape, S. Y., Black, B. K., Okamoto, L. E., Shibao, C. A., Biaggioni, I., Robertson, D., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.03.005 · Cited by 65 · see citing works
Self-citationOrthostatic hypotension: managing a difficult problem
Jones, P. K., Shaw, B. H., & Raj, S. R. (2015) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.2015.1095090 · Cited by 61 · see citing works
Self-citationDiurnal variability in orthostatic tachycardia: implications for the postural tachycardia syndrome
Brewster, J. A., Garland, E. M., Biaggioni, I., Black, B. K., Ling, J. F., Shibao, C. A., Robertson, D., & Raj, S. R. (2012) · Clinical Science · doi:10.1042/cs20110077 · Cited by 56 · see citing works
Self-citationOkamoto, L. E., Raj, S. R., Gamboa, A. C., Shibao, C. A., Arnold, A. C., Garland, E. M., Black, B. K., Farley, G., Diedrich, A., & Biaggioni, I. (2015) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00409.2015 · Cited by 57 · see citing works
Self-citationStewart, 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
Effects of exercise training on arterial-cardiac baroreflex function in POTS
Galbreath, M. M., Shibata, S., VanGundy, T. B., Okazaki, K., Fu, Q., & Levine, B. D. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-010-0091-5 · Cited by 54 · see citing works
COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review
Mallick, D. C., Goyal, L., Chourasia, P. K., Zapata, M. R., Yashi, K., & Surani, S. (2023) · Cureus · doi:10.7759/cureus.36955 · Cited by 58 · see citing works
Risk Factors for Postural Tachycardia Syndrome in Children and Adolescents
Lin, J., Han, Z., Li, X., Ochs, T., Zhao, J., Zhang, X., Yang, J., Liu, P., Xiong, Z., Gai, Y., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0113625 · Cited by 54 · see citing works
Neuronal and hormonal perturbations in postural tachycardia syndrome
Mar, P. L., & Raj, S. R. (2014) · Frontiers in Physiology · doi:10.3389/fphys.2014.00220 · Cited by 52 · see citing works
Self-citationGynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome
Peggs, K. J., Nguyen, H., Enayat, D., Keller, N. R., Al‐Hendy, A., & Raj, S. R. (2012) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2012.04.014 · Cited by 51 · see citing works
“Despite their low blood volume, patients with POTSwere found to have paradoxically low aldosterone levels and inappropriately low plasma renin activity, while having elevated concentrations of circulating angiotensin II [12,25].”
BackgroundSelf-citationVagal and Sympathetic Function in Neuropathic Postural Tachycardia Syndrome
Jacob, G., Diedrich, L., Sato, K., Brychta, R. J., Raj, S. R., Robertson, D., Biaggioni, I., & Diedrich, A. (2019) · Hypertension · doi:10.1161/hypertensionaha.118.11803 · Cited by 51 · see citing works
Self-citationOrthostatic intolerance and the headache patient
Mack, K. J., Johnson, J. N., & Rowe, P. C. (2010) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2010.04.006 · Cited by 47 · see citing works
Stewart, J. M., Taneja, I., Glover, J. L., & Medow, M. S. (2007) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.01139.2007 · Cited by 47 · see citing works
Miranda, N. A., Boris, J. R., Kouvel, K., & Stiles, L. E. (2018) · Neurology Report · doi:10.1097/npt.0000000000000231 · Cited by 45 · see citing works
Techniques Used for the Determination of Blood Volume
Ertl, A. C., Diedrich, A., & Raj, S. R. (2007) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318063c6d1 · Cited by 46 · see citing works
Self-citationMustafa, H. I., Raj, S. R., Diedrich, A., Black, B. K., Paranjape, S. Y., Dupont, W. D., Williams, G. H., Biaggioni, I., & Robertson, D. (2012) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.111.965343 · Cited by 44 · see citing works
Self-citationChronic Fatigue Syndrome and Cardiovascular Disease
Natelson, B. H., Brunjes, D. L., & MANCINI, D. M. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.06.045 · Cited by 46 · see citing works
Liao, Y., & Du, J.-B. (2020) · Neuroscience Bulletin · doi:10.1007/s12264-020-00497-4 · Cited by 39 · see citing works
Low Iron Storage in Children and Adolescents with Neurally Mediated Syncope
Jarjour, I. T., & Jarjour, L. K. (2008) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2008.01.034 · Cited by 41 · see citing works
Deficient vesicular storage: A common theme in catecholaminergic neurodegeneration
Goldstein, D. S., Holmes, C. S., Sullivan, P., Mash, D. C., Sidransky, E., Stefani, A., Kopin, I. J., & Sharabi, Y. (2015) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2015.07.009 · Cited by 39 · see citing works
Confounders of Vasovagal Syncope
Nwazue, V. C., & Raj, S. R. (2012) · Cardiology Clinics · doi:10.1016/j.ccl.2012.09.003 · Cited by 38 · see citing works
Self-citationStewart, J. M. (2012) · Expert Review of Cardiovascular Therapy · doi:10.1586/erc.12.139 · Cited by 38 · see citing works
Postural Orthostatic Tachycardia Syndrome (POTS): An Update for Clinical Practice.
Sebastian, S. A., Co, E. L., Panthangi, V., Jain, E., Ishak, A., Shah, Y., Vasavada, A., & Padda, I. (2022) · Current problems in cardiology · doi:10.1016/j.cpcardiol.2022.101384 · Cited by 33 · see citing works
Clinical challenges in the diagnosis and management of postural tachycardia syndrome
Jones, P., Shaw, B., & Raj, S. (2016) · Practical Neurology · doi:10.1136/practneurol-2016-001405 · Cited by 34 · see citing works
Self-citationvan Campen, C. M. C., Rowe, P. C., & Visser, F. C. (2021) · Journal of Translational Medicine · doi:10.1186/s12967-021-02819-0 · Cited by 36 · see citing works
Diagnosis and management of postural orthostatic tachycardia syndrome: A brief review
Abed, H., Ball, P., & Wang, L. (2012) · 老年心脏病学杂志：英文版 · doi:10.3724/sp.j.1263.2012.00061 · Cited by 36 · see citing works
Bagai, K., Wakwe, C. I., Malow, B. A., Black, B. K., Biaggioni, I., Paranjape, S. Y., Orozco, C., & Raj, S. R. (2013) · Autonomic Neuroscience · doi:10.1016/j.autneu.2013.02.021 · Cited by 35 · see citing works
Self-citationLi, H., Kem, D. C., Zhang, L., Huang, B. S., Liles, C., Benbrook, A., Gali, H., Veitla, V., Scherlag, B. J., Cunningham, M. W., et al. (2015) · Hypertension · doi:10.1161/hypertensionaha.114.05037 · Cited by 35 · see citing works
Endothelial NO Synthase Polymorphisms and Postural Tachycardia Syndrome
Garland, E. M., Winker, R., Williams, S. M., Jiang, L., Stanton, K., Byrne, D. W., Biaggioni, I., Cascorbi, I., Phillips, J. A., Harris, P. A., et al. (2005) · Hypertension · doi:10.1161/01.hyp.0000185462.08685.da · Cited by 35 · see citing works
Self-citationStewart, J. M., Taneja, I., & Medow, M. S. (2007) · Clinical Science · doi:10.1042/cs20070104 · Cited by 34 · see citing works
Hall, J., Bourne, K. M., Vernino, S., Hamrefors, V., Kharraziha, I., Nilsson, J., Sheldon, R. S., Fedorowski, A., & Raj, S. R. (2022) · Circulation · doi:10.1161/circulationaha.122.059971 · Cited by 35 · see citing works
Self-citationMelatonin reduces tachycardia in postural tachycardia syndrome: a randomized, crossover trial
Green, E. A., Black, B. K., Biaggioni, I., Paranjape, S. Y., Bagai, K., Shibao, C., Okoye, M. C., Dupont, W. D., Robertson, D., & Raj, S. R. (2014) · Cardiovascular Therapeutics · doi:10.1111/1755-5922.12067 · Cited by 33 · see citing works
Self-citationDefining Cardiac Dysautonomia – Different Types, Overlap Syndromes; Case-based Presentations
Lakkireddy, D. (2020) · Journal of Atrial Fibrillation · doi:10.4022/jafib.2403 · Cited by 33 · see citing works
Disautonomia: Uma Condição Esquecida – Parte 1
Rocha, E. A., Mehta, N., Távora‐Mehta, M. Z. P., Roncari, C. F., Cidrão, A. A. D. L., & Elías, J. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20200420 · Cited by 40 · see citing works
Acute volume loading and exercise capacity in postural tachycardia syndrome
Figueroa, R. A., Arnold, A. C., Nwazue, V. C., Okamoto, L. E., Paranjape, S. Y., Black, B. K., Diedrich, A., Robertson, D., Biaggioni, I., Raj, S. R., et al. (2014) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00367.2014 · Cited by 31 · see citing works
Self-citationMiwa, K. (2016) · Journal of Cardiology · doi:10.1016/j.jjcc.2016.06.003 · Cited by 30 · see citing works
Ivabradine in Postural Orthostatic Tachycardia Syndrome: A Review of the Literature
Tahir, F., Arif, T. B., Majid, Z., Ahmed, J., & Khalid, M. (2020) · Cureus · doi:10.7759/cureus.7868 · Cited by 28 · see citing works
Knuttinen, M.-G., Zurcher, K. S., Khurana, N., Patel, I. J., Foxx–Orenstein, A. E., Harris, L. A., Lawrence, A., Aguilar, F., Sichlau, M. J., Smith, B. H., et al. (2020) · Phlebology The Journal of Venous Disease · doi:10.1177/0268355520947610 · Cited by 28 · see citing works
Zhao, J., Tang, C., Jin, H., & Du, J. (2014) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2014.04.032 · Cited by 27 · see citing works
Evaluating and managing postural tachycardia syndrome
Lei, L. Y., Chew, D. S., Sheldon, R. S., & Raj, S. R. (2019) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.86a.18002 · Cited by 26 · see citing works
Self-citationDyspnea in Chronic Low Ventricular Preload States
Tooba, R., Mayuga, K. A., Wilson, R., & Tonelli, A. R. (2020) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202005-581cme · Cited by 26 · see citing works
Deng, W., Liu, Y., Liu, A. D., Holmberg, L., Ochs, T., Li, X., Yang, J., Tang, C., Du, J., & Jin, H. (2013) · Pediatric Cardiology · doi:10.1007/s00246-013-0843-9 · Cited by 28 · see citing works
Fear conditioning as a pathogenic mechanism in the postural tachycardia syndrome
Norcliffe‐Kaufmann, L., Palma, J., Martinez, J., Camargo, C., & Kaufmann, H. (2022) · Brain · doi:10.1093/brain/awac249 · Cited by 26 · see citing works
Postural orthostatic tachycardia syndrome: New concepts in pathophysiology and management
Grubb, A. F., & Grubb, B. P. (2021) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2021.10.007 · Cited by 26 · see citing works
Erythrocytic Hydrogen Sulfide Production Is Increased in Children with Vasovagal Syncope
Yang, J., Li, H., Ochs, T., Zhao, J., Zhang, Q., Du, S., Chen, Y., Liu, P., Wang, Y., Feng, X., et al. (2015) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2014.12.021 · Cited by 25 · see citing works
Postural Tachycardia Syndrome in Children and Adolescents: Pathophysiology and Clinical Management
Chen, G.-Z., Du, J.-B., Jin, H.-F., & Huang, Y.-Q. (2020) · Frontiers in Pediatrics · doi:10.3389/fped.2020.00474 · Cited by 24 · see citing works
- Authors
- Raj, S. R., Biaggioni, I., Yamhure, P. C., Black, B. K., Paranjape, S. Y., Byrne, D. W., & Robertson, D.
- Affiliations
- Vanderbilt University (US)
- Venue
- Circulation
- Published
- 2005-04-05
- Volume
- 111
- Issue
- 13
- Pages
- 1574-1582
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2104389637
- Semantic Scholar
- e12b9205141272d6254be2fee9f95b225517fc05
- Cited by
- 286
- References
- 44
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 22 · 2023: 13 · 2022: 14 · 2021: 18 · 2020: 26 · 2019: 14 · 2018: 13 · 2017: 10 · 2016: 9 · 2015: 14 · 2014: 16 · 2013: 10 · 2012: 15
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vanderbilt University (M01 RR00095)
- National Institutes of Health
- National Heart, Lung, and Blood Institute (2P01-HL-56693, P01HL056693)
- National Center for Research Resources (M01RR000095, M01-RR-00095)
- 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 › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- postural orthostatic tachycardia syndrome, plasma volume, hypovolemia, renin-aldosterone system, plasma renin activity, aldosterone, erythrocyte volume, erythropoietin, blood volume regulation, renal pathophysiology
- MeSH terms
- Adult, Aldosterone, Blood Volume, Erythropoietin, Female, Hemodynamics, Humans, Male, Middle Aged, Posture, Prospective Studies, Renin, Renin-Angiotensin System, Tachycardia, Case-Control Studies, Hypovolemia
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
