Cited by 112Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlCardiovascular and exercise physiology

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Deconditioning in patients with orthostatic intolerance

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Parsaik, Ajay, Allison, Thomas G., Singer, Wolfgang, Sletten, David M., Joyner, Michael J., Benarroch, Eduardo E., Low, Phillip A., Sandroni, Paola·2012·Neurology

DOI 10.1212/wnl.0b013e31826d5f95PMC PMC3525293

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Abstract

OBJECTIVE: To study the frequency and degree of deconditioning, clinical features, and relationship between deconditioning and autonomic parameters in patients with orthostatic intolerance. METHODS: We retrospectively studied all patients seen for orthostatic intolerance at Mayo Clinic between January 2006 and June 2011, who underwent both standardized autonomic and exercise testing. RESULTS: A total of 184 patients (84 with postural orthostatic tachycardia syndrome [POTS] and 100 without orthostatic tachycardia) fulfilled the inclusion criteria. Of these, 89% were women, and median age was 27.5 years (interquartile range [IQR] 22-37 years). Symptom duration was 4 years (IQR 2-7.8). Of the patients, 90% had deconditioning (reduced maximum oxygen uptake [VO(2max)%] <85%) during exercise. This finding was unrelated to age, gender, or duration of illness. The prevalence of deconditioning was similar between those with POTS (95%) and those with orthostatic intolerance (91%). VO(2max)% had a weak correlation with a few autonomic and laboratory parameters but adequate predictors of VO(2max)% could not be identified. CONCLUSION: Reduced VO(2max)% consistent with deconditioning is present in almost all patients with orthostatic intolerance and may play a central role in pathophysiology. This finding provides a strong rationale for retraining in the treatment of orthostatic intolerance. None of the autonomic indices are reliable predictors of deconditioning.

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Gibbons CH, Freeman R . Intense cardiovascular exercise as a treatment for non-neuropathic postural tachycardia syndrome (POTS). Neurology 2011; 76 (suppl 4): A264.

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Reconditioning advised in orthostatic intolerance
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Authors: Parsaik, A., Allison, T. G., Singer, W., Sletten, D. M., Joyner, M. J., Benarroch, E. E., Low, P. A., & Sandroni, P.
Affiliations: Mayo Clinic (US)
ORCID: Parsaik, Ajay
Allison, Thomas G.
Singer, Wolfgang
Joyner, Michael J.
Benarroch, Eduardo E.
Low, Phillip A.
Sandroni, Paola
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2012-10-02
Volume: 79
Issue: 14
Pages: 1435-1439
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.0b013e31826d5f95
PMC: PMC3525293
OpenAlex: W2102895149
Cited by: 111
References: 13
Citations by year: 2026: 3 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 12 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 7 · 2015: 10 · 2014: 6 · 2013: 6 · 2012: 4
FWCI: 8.42
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Neurology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Georgia Clinical and Translational Science Alliance
Rare Diseases Clinical Research Network
National Institutes of Health (NS4 4233, NS3 2352, RR24150)
National Institute of Neurological Disorders and Stroke (NS3 2352, P01NS044233, NS-44233, U54NS065736, K23NS075141)
National Center for Research Resources (UL1RR024150)
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 › Physiology (medical) › Cardiovascular and exercise physiology
Keywords: orthostatic intolerance, deconditioning, postural orthostatic tachycardia syndrome, autonomic dysfunction, VO2max, exercise capacity, autonomic function testing
MeSH terms: Adult, Blood Pressure, Exercise Test, Female, Heart Rate, Humans, Male, Reflex, Retrospective Studies, Valsalva Maneuver, Cardiovascular Deconditioning, Statistics, Nonparametric, Orthostatic Intolerance, Postural Orthostatic Tachycardia Syndrome, Young Adult

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