POTS can not be solely due to deconditioning - German study

Dolphin

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A corollary from this might be that getting a person with POTS to exercise may not make them no longer have POTS.

Exercise Performance in Adolescents with Autonomic Dysfunction.

Journal: J Pediatr. 2010 Aug 31. [Epub ahead of print]

Burkhardt BE, Fischer PR, Brands CK, Porter CB, Weaver AL, Yim PJ, Pianosi PT.

Department of Pediatric Cardiology and Congenital Heart Disease, University Medical Center Freiburg, Freiburg, Germany.


Abstract

OBJECTIVE: To test the hypothesis that excessive postural tachycardia is associated with deconditioning rather than merely being an independent sign of autonomic dysfunction in patients with postural orthostatic tachycardia syndrome (POTS).

STUDY DESIGN: We retrospectively analyzed records from 202 adolescents who underwent both head up-tilt and maximal exercise testing. Patients were classified as POTS if they had >/=30 min(-1) rise in heart rate (HR) after tilt-table test; and deconditioned if peak O(2) uptake was <80% predicted.
Changes in HR during exercise and recovery were compared between groups.

RESULTS: Two-thirds of patients were deconditioned, irrespective of whether they fulfilled diagnostic criteria for POTS, but peak O(2) uptake among patients with POTS was similar to patients without POTS. HR was higher at rest and during exercise; whereas stroke volume was lower during exercise, and HR recovery was slower in patients with POTS compared with patients without POTS.

CONCLUSIONS: Most patients who presented with chronic symptoms of dizziness, fatigue, or pre-syncope, were deconditioned, but, because the proportion of deconditioned patients was similar in POTS vs non-POTS groups, we conclude that HR changes in POTS are not solely because of inactivity resulting in deconditioning.

PMID: 20813382 [PubMed - as supplied by publisher]
 

alex3619

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Hi Dolphin, indeed they haven't even shown why people appear to be deconditioned. I would argue that some at least have physical problems preventing good performance. In other words, rather than looking for a correlation between deconditioning and POTS, they should have been looking for some common factor that leads to both (such as undiagnosed ME, but there could be other things). I hate such superficial studies, but I do have to say that since I haven't read the whole paper they may indeed have tried to examine other issues: abstracts are very unreliable.

Bye
Alex
 

heapsreal

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i think with cfs symptoms it depends where the virus hit us, it seems to hit everyone in the nervous system in some way, for me its the sleep centre and memory, for others its pots and some get alot of pain i think because it can hit the nerves in some way. As far a deconditioning go's, i know with me sometimes i can do something physical with not too many problems and the next week do the same thing again and struggle, if it was deconditioning this wouldnt happen. I think it may have alot to do with viral/retroviral reactivation which could increase inflammatory chemicals etc which disable us just that bit more then when no reactivation is going on.

cheers!!!
 

bakercape

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I so agree

i think with cfs symptoms it depends where the virus hit us, it seems to hit everyone in the nervous system in some way, for me its the sleep centre and memory, for others its pots and some get alot of pain i think because it can hit the nerves in some way. As far a deconditioning go's, i know with me sometimes i can do something physical with not too many problems and the next week do the same thing again and struggle, if it was deconditioning this wouldnt happen. I think it may have alot to do with viral/retroviral reactivation which could increase inflammatory chemicals etc which disable us just that bit more then when no reactivation is going on.

cheers!!!
With everything you are saying here. I read somewhere that a high percentage of Pots that began in teenagers started after a case of Mono. A virus or retrovirus in my mind must be a contributer or initiater of POTS in many many cases. Either directly in the nervous system or indirectly through cytokine production.