The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.
Postural Tachycardia Syndrome (POTS)
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In the citing paper
“The HRPeak during HUT was also lower with both drugs, reinforcing their ability to blunt excessive orthostatic tachycardia, the key physiological impact of POTS.2,3”
From A Randomized Crossover Trial of Ivabradine, Propranolol, and Placebo in Postural Orthostatic Tachycardia Syndrome (2026) · cites this paper as [2]
In the citing paper
“This is felt to be a reflection of exaggerated sympathetic neuronal activation (97).”
From Postural Orthostatic Tachycardia Syndrome (2019) · cites this paper as [97]
In the citing paper
“The HR abnormality must be accompanied by chronic (>6 months) orthostatic symptoms that occur in the absence of prolonged bedrest or deconditioning, use of medications that impair autonomic regulation (vasodilators, diuretics, antidepressants, or anxiolytic agents), or other chronic debilitating disorders that might cause tachycardia (such as dehydration, anemia, or hyperthyroidism) [19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“When measured during upright posture, norepinephrine is elevated in many patients with POTS [>3.55 nmol/L (600 pg/mL) and sometimes >5.91 nmol/L (1000 pg/mL)], consistent with the sympathetic neuronal activation elicited by standing in these patients [19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Central sympatholytics (e.g. clonidine and methyldopa) can also be used to decrease sympathetic tone in patients with prominent hyperadrenergic features, but might produce drowsiness and worsening of the mental clouding [19] (HRS Class IIb) [8].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Abdominal compression with elastic waist-high support hose and abdominal binders can help decrease splanchnic-mesenteric venous pooling during standing [43]. The increase in venous return and stroke volume can decrease the orthostatic tachycardia [19;59].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Central sympatholytics (e.g. clonidine and methyldopa) can also be used to decrease sympathetic tone in patients with prominent hyperadrenergic features, but might produce drowsiness and worsening of the mental clouding [19] (HRS Class IIb) [8].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“More generalized complaints in patients with POTS include hypermobile joints, exercise intolerance, migraine headaches, sleep disturbances, and fatigue [19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Excessive tachycardia in POTS occurs during exercise as well as during standing [60;61], and patients experience significant exercise intolerance [9;19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Autonomic problems in POTS might include gastrointestinal complaints, such as abdominal pain, nausea and irritable bowel syndrome, as well as bladder symptoms and abnormal sudomotor regulation [19;26].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Patients with POTS often have a vigorous pressor response, with exaggerated BP recovery and overshoot both before and after release [19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“The heart rate abnormality and orthostatic symptoms should not be caused by medications that impair autonomic regulation or by debilitating disorders that can cause tachycardia.”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Fludrocortisone also stimulates potassium excretion, making it necessary to watch for hypokalemia, and it can also worsen migraine headaches [71;19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Fludrocortisone also stimulates potassium excretion, making it necessary to watch for hypokalemia, and it can also worsen migraine headaches [71;19].”
From Postural tachycardia syndrome: beyond orthostatic intolerance (2015) · cites this paper as [19]
In the citing paper
“Pyridostigmine enhances cholinergic activity at both the ganglionic nicotinic and the postganglionic muscarinic acetylcholine receptors, with a likely net increase in parasympathetic nervous system tone (3).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [3]
Citations
Cites
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
The neuropathic postural tachycardia syndrome
Jacob, G., Costa, F., Shannon, J. R., Robertson, R. M., Wathen, M., Stein, M., Biaggioni, I., Ertl, A., Black, B., & Robertson, D. (2000) · New England Journal of Medicine · doi:10.1056/nejm200010053431404 · Cited by 398
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
Raj, S. R., Biaggioni, I., Yamhure, P. C., Black, B. K., Paranjape, S. Y., Byrne, D. W., & Robertson, D. (2005) · Circulation · doi:10.1161/01.cir.0000160356.97313.5d · Cited by 286
Self-citationRaj, 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 · cited 1×
“19 More complete β-blockade, however, is less well tolerated.(19) Pyridostigmine is a peripheral acetylcholinesterase inhibitor that can increase the levels of synaptic acetylcholine at both the autonomic ganglia and peripheral muscarinic parasympathetic receptors.”
BackgroundSelf-citationHyperadrenergic Postural Tachycardia Syndrome in Mast Cell Activation Disorders
Shibao, C., Arzubiaga, C., Roberts, L. J., Raj, S., Black, B., Harris, P., & Biaggioni, I. (2005) · Hypertension · doi:10.1161/01.hyp.0000158259.68614.40 · Cited by 220
Self-citationQuality of Life in Patients With Postural Tachycardia Syndrome
Benrud-Larson, L. M., Dewar, M. S., Sandroni, P., Rummans, T. A., Haythornthwaite, J. A., & Low, P. A. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.6.531 · Cited by 217
Postural tachycardia in children and adolescents: what is abnormal?
Singer, W., Sletten, D. M., Opfer-Gehrking, T. L., Brands, C. K., Fischer, P. R., & Low, P. A. (2012) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2011.08.054 · Cited by 209
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
(2006) · PubMed · Cited by 190
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Chaudhury, D., Atia, N., Obiechina, N., Gill, A., Michael, A., & Sampathy, K. (2025) · Cureus · doi:10.7759/cureus.97581
Go, S., Kasuga, A., Hayashi, K., Murakami, M., Minami, S., Matsumoto, W., Takahashi, R., Watanabe, Y., Saito, N., Ohno, K., et al. (2025) · Clinical Autonomic Research · doi:10.1007/s10286-025-01169-x
Pearce, G., Holliday, N., Sandhu, H., Eftekhari, H., Bruce, J., Timms, E., Ablett, L., Kavi, L., Simmonds, J. V., Evans, R., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23961931
Taoussi, O., Kamri, H. A., Scadi, S., Ghali, B., & Merzouk, F. (2026) · Cureus · doi:10.7759/cureus.101268
Hyperadrenergic postural tachycardia syndrome associated with augmented neurovascular transduction
Kulapatana, S., Okamoto, L. E., Rigo, S., Urechie, V., Cayton, T. W., Han, R. E., Jacob, G., Dupont, W. D., Furlan, R., Biaggioni, I., et al. (2026) · Clinical Autonomic Research · doi:10.1007/s10286-025-01183-z
Chen, J.-H., Chen, M. L., Wu, Z.-Y., Luo, Q.-M., & Tu, Y.-Y. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1724482
Ilyas, M., Barlas, S., Abid, M., & Hussain, M. (2026) · Cureus · doi:10.7759/cureus.105923
Zhang, K. Y., Higgins, E., Morant, A. V., & Hamidi, F. (2025) · Maryland Shared Open Access Repository (USMAI Consortium) · doi:10.13016/m2a8w3-54f4
Fatima, S. S., Ayaz, S. N., Raza, A. A., & Samadi, A. (2026) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000005070
Zitser, P., Kolomiyets, I., Imran, M., Kulkarni, A., Patel, J., Martin, N. S., & Ahmadi, A. (2026) · Cureus · doi:10.7759/cureus.108903
Rahali, Z., Boussaadani, B. E., & Raissuni, Z. (2026) · Annales de Cardiologie et d Angéiologie · doi:10.1016/j.ancard.2026.102018
Kakavand, B., Ebadi, A. A., Kakavand, A. A., & Rueda-de-Leon, E. (2026) · Pediatric Cardiology · doi:10.1007/s00246-026-04355-4
Tellier, R. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1865449
Diagnostische Verfahren zur Bestimmung der Faszienelastizität
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Tamilson, B., Fenske, O., Morrin, H., Coebergh, J. A., Agrawal, N., Owens, A. P., Lim, P. B., & Poole, N. A. (2026) · Swiss Archives of Neurology Psychiatry and Psychotherapy · doi:10.3390/sanpp176020010
Tiotsop, M., Roger, D. O., Sama, R., Ande, E., & Salabei, J. K. (2026) · Clinical Autonomic Research · doi:10.1007/s10286-026-01233-0
Hypoglycemic Flash as a potential shared metabolic trigger for episodic autonomic disorders
Shigeto, M. (2026) · Medical Hypotheses · doi:10.1016/j.mehy.2026.112124
Chin, A. Y., Rilinger, R. G., Leboit, P., Levine, M. A., Nowacki, A. S., Brant, A. R., Cameron, C., Gubbels, A. L., & Wilson, R. (2026) · Clinical Autonomic Research · doi:10.1007/s10286-026-01244-x
Gabriel, A. S., Smiley, A., Rocco, P., Johnson, K., Cortez, M. M., & Finkelstein, J. (2026) · Communications in computer and information science · doi:10.1007/978-3-032-28463-1_27
Beyond Pain Intensity: A Patient-Informed Framework for Documenting Burden in Small Fiber Neuropathy
Hochman, G. (2026) · Neurology and Therapy · doi:10.1007/s40120-026-01063-2
Metadata
- Authors
- Raj, S. R.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Raj, Satish R.
- ORCID
- Raj, Satish R.
- Venue
- Circulation
- Published
- 2013-06-11
- Volume
- 127
- Issue
- 23
- Pages
- 2336-2342
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3756553
- OpenAlex
- W2162352430
- Cited by
- 320
- References
- 20
- Citations by year
- 2026: 22 · 2025: 21 · 2024: 21 · 2023: 24 · 2022: 26 · 2021: 23 · 2020: 26 · 2019: 23 · 2018: 28 · 2017: 28 · 2016: 20 · 2015: 14 · 2014: 17 · 2013: 2
- FWCI
- 17.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000445)
- National Heart, Lung, and Blood Institute (P01HL056693, R01HL102387, P01 HL-56693)
- National Institute of Neurological Disorders and Stroke (U54NS065736)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, orthostatic intolerance, autonomic dysfunction, heart rate, blood pressure
- MeSH terms
- Contraindications, Adult, Androstenes, Anxiety, Blood Volume, Cardiovascular Agents, Combined Modality Therapy, Confusion, Diagnosis, Differential, Fatigue, Female, Hemodynamics, Humans, Leg, Mast Cells, Norepinephrine, Posture, Renin-Angiotensin System, Sodium Chloride, Sympathetic Nervous System, Syncope, Syndrome, Tachycardia, Catheter Ablation, Norepinephrine Plasma Membrane Transport Proteins
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