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Fortschr Neurol Psychiatr 2011; 79(2): 117-125
DOI: 10.1055/s-0029-1245991
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© Georg Thieme Verlag KG Stuttgart · New York

Das Posturale Tachykardiesyndrom (POTS): Aktuelle Konzepte zur Pathophysiologie, Diagnose und Therapie

Postural Orthostatic Tachycardia Syndrome: Current Concepts in Pathophysiology, Diagnosis and Therapeutic OptionsC.-A. Haensch1 , S. Isenmann2
  • 1Autonomes Labor der Klinik für Neurologie der Universität Witten/Herdecke, HELIOS Klinikum Wuppertal
  • 2Klinik für Neurologie der Universität Witten/Herdecke, HELIOS Klinikum Wuppertal
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Publication History

Publication Date:
20 January 2011 (online)

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Lernziele

Der vorliegende Beitrag befasst sich mit dem posturalen Tachykardiesyndrom. Ziel ist es, folgende Kenntnisse über das Syndrom zu vermitteln:

Definition, Klinik, Pathophysiologie Diagnose und autonome Funktionsdiagnostik Therapie

Literatur

  • 1 Grubb B P. Idiopathic postural orthostatic tachycardia syndrome.  J UOEH. 2000;  22 239-245
    Google Scholar
  • 2 Grubb B P, Kanjwal Y, Kosinski D J. The postural tachycardia syndrome: a concise guide to diagnosis and management.  J Cardiovasc Electrophysiol. 2006;  17 108-112
    Google Scholar
  • 3 Low P A, Sandroni P, Joyner M et al. Postural tachycardia syndrome (POTS).  J Cardiovasc Electrophysiol. 2009;  20 352-358
    Google Scholar
  • 4 Thieben M J, Sandroni P, Sletten D M et al. Postural orthostatic tachycardia syndrome: the Mayo clinic experience.  Mayo Clin Proc. 2007;  82 308-313
    Google Scholar
  • 5 Glatter K A, Tuteja D, Chiamvimonvat N et al. Pregnancy in postural orthostatic tachycardia syndrome.  Pacing Clin Electrophysiol. 2005;  28 591-593
    Google Scholar
  • 6 Kanjwal K, Karabin B, Kanjwal Y et al. Outcomes of pregnancy in patients with preexisting postural tachycardia syndrome.  Pacing Clin Electrophysiol. 2009;  32 1000-1003
    Google Scholar
  • 7 Kimpinski K, Iodice V, Sandroni P et al. Effect of pregnancy on postural tachycardia syndrome.  Mayo Clin Proc. 2010;  85 639-644
    Google Scholar
  • 8 Kodakkattil S, Das S. Pregnancy in woman with postural orthostatic tachycardia syndrome (POTS).  J Obstet Gynaecol. 2009;  29 764-765
    Google Scholar
  • 9 Powless C A, Harms R W, Watson W J. Postural tachycardia syndrome complicating pregnancy.  J Matern Fetal Neonatal Med. 2010;  23 850-853
    Google Scholar
  • 10 Haensch C A, Jörg J. Diagnostic value of autonomic testing versus conventional evaluation in syncope of unexplained origin.  Clin Auton Res. 2002;  12 329
    Google Scholar
  • 11 Haensch C A, Jörg J. Autonomic testing in syncope.  J Neurol. 2002;  249 24
    Google Scholar
  • 12 Schondorf R, Low P A. Idiopathic postural orthostatic tachycardia syndrome: an attenuated form of acute pandysautonomia?.  Neurology. 1993;  43 132-137
    Google Scholar
  • 13 Schondorf R, Benoit J, Wein T et al. Orthostatic intolerance in the chronic fatigue syndrome.  J Auton Nerv Syst. 1999;  75 192-201
    Google Scholar
  • 14 Robertson D. The epidemic of orthostatic tachycardia and orthostatic intolerance.  Am J Med Sci. 1999;  317 75-77
    Google Scholar
  • 15 Diehl R R, Linden D. Differential orthostatic dysregulation disorders diagnosis.  Nervenarzt. 1999;  70 1044-1051
    Google Scholar
  • 16 Stewart J M, Weldon A. The relation between lower limb pooling and blood flow during orthostasis in the postural orthostatic tachycardia syndrome of adolescents.  J Pediatr. 2001;  138 512-519
    Google Scholar
  • 17 Jacob G, Costa F, Shannon J R et al. The neuropathic postural tachycardia syndrome.  N Engl J Med. 2000;  343 1008-1014
    Google Scholar
  • 18 Al-Shekhlee A, Lindenberg J R, Hachwi R N et al. The value of autonomic testing in postural tachycardia syndrome.  Clin Auton Res. 2005;  15 219-222
    Google Scholar
  • 19 Haensch C A, Lerch H, Jigalin A et al. Cardiac denervation in postural tachycardia syndrome.  Clin Auton Res. 2008;  18 40-42
    Google Scholar
  • 20 Haensch C A, Lerch H, Schlemmer H et al. Cardiac neurotransmission imaging with 123I-meta-iodobenzylguanidine in postural tachycardia syndrome.  J Neurol Neurosurg Psychiatry. 2010;  81 339-343
    Google Scholar
  • 21 Stewart J M, Taneja I, Medow M S. Reduced central blood volume and cardiac output and increased vascular resistance during static handgrip exercise in postural tachycardia syndrome.  Am J Physiol Heart Circ Physiol. 2007;  293 H1908-H1917
    Google Scholar
  • 22 Vernino S, Low P A, Fealey R D et al. Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies.  N Engl J Med. 2000;  343 847-855
    Google Scholar
  • 23 Vernino S, Sandroni P, Singer W et al. Invited Article: Autonomic ganglia: target and novel therapeutic tool.  Neurology. 2008;  70 1926-1932
    Google Scholar
  • 24 Garland E M, Raj S R, Black B K et al. The hemodynamic and neurohumoral phenotype of postural tachycardia syndrome.  Neurology. 2007;  69 790-798
    Google Scholar
  • 25 Shannon J R, Flattem N L, Jordan J et al. Orthostatic intolerance and tachycardia associated with norepinephrine-transporter deficiency.  N Engl J Med. 2000;  342 541-549
    Google Scholar
  • 26 Nickander K K, Carlson P J, Urrutia R A et al. A screen of candidate genes and influence of beta2-adrenergic receptor genotypes in postural tachycardia syndrome.  Auton Neurosci. 2005;  120 97-103
    Google Scholar
  • 27 Keller N R, Robertson D. Familial orthostatic tachycardia.  Curr Opin Cardiol. 2006;  21 173-179
    Google Scholar
  • 28 Robertson D, Flattem N, Tellioglu T et al. Familial orthostatic tachycardia due to norepinephrine transporter deficiency.  Ann N Y Acad Sci. 2001;  940 527-543
    Google Scholar
  • 29 Terlizzi R, Rocchi C, Serra M et al. Reversible postural tachycardia syndrome due to inadvertent overuse of Red Bull.  Clin Auton Res. 2008;  18 221-223
    Google Scholar
  • 30 Gazit Y, Nahir A M, Grahame R et al. Dysautonomia in the joint hypermobility syndrome.  Am J Med. 2003;  115 33-40
    Google Scholar
  • 31 Masuki S, Eisenach J H, Johnson C P et al. Excessive heart rate response to orthostatic stress in postural tachycardia syndrome is not caused by anxiety.  J Appl Physiol. 2007;  102 896-903
    Google Scholar
  • 32 Benrud-Larson L M, Sandroni P, Haythornthwaite J A et al. Correlates of functional disability in patients with postural tachycardia syndrome: preliminary cross-sectional findings.  Health Psychol. 2003;  22 643-648
    Google Scholar
  • 33 Haensch C, Wagner C, Isenmann S. Discrimination of somatic symptoms and anxiety in postural tachycardia syndrome.  J Neurol Sci. 2009;  285 145-146
    Google Scholar
  • 34 Raj V, Haman K L, Raj S R et al. Psychiatric profile and attention deficits in postural tachycardia syndrome.  J Neurol Neurosurg Psychiatry. 2009;  80 339-344
    Google Scholar
  • 35 Khurana R K. Experimental induction of panic-like symptoms in patients with postural tachycardia syndrome.  Clin Auton Res. 2006;  16 371-377
    Google Scholar
  • 36 Haensch C A, Jörg J. Die Analyse der Blutdruckregulation bei autonomer Dysfunktion.  Klin Neurophysiol. 2005;  36 86-97
    Google Scholar
  • 37 Haensch C A, Jost W. Das Autonome Nervensystem. Stuttgart: Kohlhammer; 2009: 394
    Google Scholar
  • 38 Haensch C A, Isenmann S. Autonome Diagnostik in der klinischen Praxis.  Neurophysiol Lab. 2009;  31 177-191
    Google Scholar
  • 39 Mayuga K A, Butters K B, Fouad-Tarazi F. Early versus late postural tachycardia: a re-evaluation of a syndrome.  Clin Auton Res. 2008;  18 155-157
    Google Scholar
  • 40 Sandroni P, Novak V, Opfer-Gehrking T L et al. Mechanisms of blood pressure alterations in response to the Valsalva maneuver in postural tachycardia syndrome.  Clin Auton Res. 2000;  10 1-5
    Google Scholar
  • 41 Haensch C A, Mosblech C, Jörg J. Die Sympathische Hautreaktion.  Neurophysiol Lab. 2001;  23 192-206
    Google Scholar
  • 42 El-Sayed H, Hainsworth R. Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope.  Heart. 1996;  75 134-140
    Google Scholar
  • 43 Hilz M J, Marthol H, Neundorfer B. Syncope – a systematic overview of classification, pathogenesis, diagnosis and management.  Fortschr Neurol Psychiatr. 2002;  70 95-107
    Google Scholar
  • 44 Stewart J M, Munoz J, Weldon A. Clinical and physiological effects of an acute alpha-1 adrenergic agonist and a beta-1 adrenergic antagonist in chronic orthostatic intolerance.  Circulation. 2002;  106 2946-2954
    Google Scholar
  • 45 Singer W, Opfer-Gehrking T L, Nickander K K et al. Acetylcholinesterase inhibition in patients with orthostatic intolerance.  J Clin Neurophysiol. 2006;  23 476-481
    Google Scholar
  • 46 Hoeldtke R D, Bryner K D, Hoeldtke M E et al. Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine.  Clin Auton Res. 2006;  16 390-395
    Google Scholar
  • 47 Hoeldtke R D, Bryner K D, Hoeldtke M E et al. Treatment of autonomic neuropathy, postural tachycardia and orthostatic syncope with octreotide LAR.  Clin Auton Res. 2007;  17 334-340
    Google Scholar
  • 48 Grubb B P, Klingenheben T. Postural orthostatic tachycardia syndrome (POTS): etiology, diagnosis and therapy.  Med Klin. 2000;  95 442-446
    Google Scholar
  • 49 Ewan V, Norton M, Newton J L. Symptom improvement in postural orthostatic tachycardia syndrome with the sinus node blocker ivabradine.  Europace. 2007;  9 1202
    Google Scholar
  • 50 Schulze V, Steiner S, Hennersdorf M et al. Ivabradine as an alternative therapeutic trial in the therapy of inappropriate sinus tachycardia: a case report.  Cardiology. 2008;  110 206-208
    Google Scholar
  • 51 Aliyev F, Celiker C, Turkoglu C et al. Successful use of ivabradine in a case of exaggerated autonomic dysfunction.  Turk Kardiyol Dern Ars. 2010;  38 285-289
    Google Scholar

Priv.-Doz. Dr. Carl-Albrecht Haensch

Autonomes Labor der Klinik für Neurologie der Universität Witten/Herdecke, HELIOS Klinikum Wuppertal

Heusnerstr. 40

42283 Wuppertal

Email: carl-albrecht.haensch@helios-kliniken.de