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. 2020 Aug 13;17(16):5872.
doi: 10.3390/ijerph17165872.

Time Course of Autonomic Symptoms in Postural Orthostatic Tachycardia Syndrome (POTS) Patients: Two-Year Follow-Up Results

Franca Dipaola  1   2 , Caterina Barberi  1 , Elena Castelnuovo  1 , Maura Minonzio  1 , Roberto Fornerone  1 , Dana Shiffer  1 , Beatrice Cairo  3 , Antonio Roberto Zamuner  4 , Franca Barbic  1   2 , Raffaello Furlan  1   2
Affiliations
Free PMC article

Time Course of Autonomic Symptoms in Postural Orthostatic Tachycardia Syndrome (POTS) Patients: Two-Year Follow-Up Results

Franca Dipaola et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

Postural orthostatic tachycardia syndrome (POTS) is a multifactorial condition capable of chronically reducing the quality of life and the work ability of patients. The study aim was to assess the burden of autonomic symptoms in a cohort of POTS patients over 2 years. Patients' clinical profiles were assessed by the 31-item Composite Autonomic Symptom Score questionnaire (COMPASS 31) and a visual analog scale (VAS). One-way ANOVA for repeated measures followed by Dunnett's post-hoc test were used to compare symptoms at baseline and at 1 and 2 years. Out of 42 enrolled patients, 25 had a 1-year follow-up and 12 had a 2-year follow-up. At baseline, the reported burden of autonomic symptoms was high (overall COMPASS 31 = 49.9 ± 14.3 /100). Main complaints were related to orthostatic intolerance according to both COMPASS 31 and VAS. Fourteen patients were rendered inactive because of symptoms. At 1-year follow-up, a statistically significant improvement in pupillomotor function and overall score was detected by the COMPASS 31. These findings were confirmed at 2 years, together with a significant reduction in quality of life impairment, assessed by VAS. However, these improvements did not change patients' occupational status. Awareness of POTS diagnosis, patient monitoring, and tailored therapies can help to improve patients' condition.

Keywords: POTS; orthostatic hypotension; syncope; working.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Baseline autonomic symptom assessment by COMPASS 31 questionnaire. OI indicates orthostatic intolerance domain; Vasomotor, vasomotor function domain; Secretomotor, secretomotor function domain; Gastrointestinal, gastrointestinal function domain; Bladder, bladder function domain; Pupillomotor, pupillomotor function domain; tot/COMPASS 31, total COMPASS 31 score. The scores are here represented as a percentage of the maximum value obtainable in each domain.
Figure 2
Figure 2
Autonomic symptom assessment at baseline by modified VAS. OI indicates orthostatic intolerance; Excretory, excretory function; Gastrointestinal, gastrointestinal function; Genito-urinary, genito-urinary function; Visual, visual acuity.
Figure 3
Figure 3
Baseline autonomic symptom assessment by COMPASS 31 according to gender. OI indicates orthostatic intolerance domain; Vasomotor, vasomotor function domain; Secretomotor, secretomotor function domain; Gastrointestinal, gastrointestinal function domain; Bladder, bladder function domain; Pupillomotor, pupillomotor function domain; tot/COMPASS 31, total COMPASS 31 score. The scores are here represented as a percentage of the maximum value obtainable in each domain.
Figure 4
Figure 4
Autonomic symptom assessment at baseline by modified VAS according to gender. OI indicates orthostatic intolerance; Excretory, excretory function; Gastrointestinal, gastrointestinal function; Genito-urinary, genito-urinary function; Visual, visual acuity.
Figure 5
Figure 5
COMPASS 31 total score comparison between baseline and 1-year and 2-year follow-up. B indicates baseline. * indicates p < 0.05 12 months vs. baseline; § indicates p < 0.05 24 months vs. baseline. Results are expressed as mean ± SD.
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