サトウ キヨウコ   Satou Kiyouko
  佐藤 恭子
   所属   医学部 医学科(附属足立医療センター)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Distal sudomotor findings in postural tachycardia syndrome.
掲載誌名 正式名:Clinical autonomic research : official journal of the Clinical Autonomic Research Society
略  称:Clin Auton Res
ISSNコード:1619-1560(Electronic)0959-9851(Linking)
巻・号・頁 20(2),pp.93-9
著者・共著者 Peltier Amanda Catherine, Garland Emily, Raj Satish R, Sato Kyoko, Black Bonnie, Song Yanna, Wang Lily, Biaggioni Italo, Diedrich Andre, Robertson David
発行年月 2010/04
概要 OBJECTIVES:Postural tachycardia syndrome (POTS) is a heterogeneous disorder characterized by excessive orthostatic tachycardia in the absence of orthostatic hypotension and by sympathetic nervous system activation. Postganglionic sudomotor deficits have been used to define a neurogenic postural tachycardia POTS subtype. Norepinephrine levels aboveOBJECTIVES:600 pg/ml have also been used to delineate patients with a hyperadrenergic state. This study aims to determine the relationship of sudomotor abnormalities to other aspects of dysautonomia in POTS.METHODS:Autonomic function was quantified in thirty women through tests of cardiovagal, adrenergic, and sudomotor function including quantitative sudomotor axon reflex testing (QSART) and spectral indices. Differences between patients with and without sudomotor dysfunction as defined by QSART and between patients with and without hyperadrenergic POTS were assessed with Mann-Whitney U test and Mantel-Haenszel Chi-Square test using a p value of 0.01 for significance. Spearman correlation coefficients were used to test raw sweat volume correlations with other variables.RESULTS:Of 30 women (ages 20-58), 17 patients (56%) had an abnormal QSART which was typically patchy and involved the lower extremity, while 13 patients had normal QSART results. Other autonomic tests, catecholamines or spectral indices did not correlate with QSART results. No differences in autonomic tests or spectral indices were observed between hyperadrenergic and non-hyperadrenergic POTS.INTERPRETATION:Our findings confirm that a large subset of POTS patients have sudomotor abnormalities which are typically patchy in distribution but do not correlate with other tests of autonomic function. Further studies are needed to determine the best method of endophenotyping patients with POTS.
DOI 10.1007/s10286-009-0045-y
文献番号 20035362