title: Orthostatic intolerance in survivors of childhood cancer.
abstract: OBJECTIVE
  To compare the prevalence and severity of orthostatic intolerance in survivors of childhood cancer and in healthy controls, and to correlate results of self-reported measures of health status with orthostatic testing in survivors of childhood cancer.
  
  
  METHODS
  Thirty-nine survivors of childhood cancer and 56 controls were recruited for this study. Each cancer survivor completed standardised self-report measures and all participants underwent a standing test (5 min supine, 10 min of motionless standing leaning against a wall, followed by another 2 min supine). The main outcomes of the standing test were orthostatic tachycardia (OT), defined as a heart rate increase of at least 30 beats per minute (bpm) during standing, and neurally mediated hypotension (NMH), defined as a drop in systolic blood pressure of at least 25 mmHg.
  
  
  RESULTS
  OT developed in 22/39 (56%) cancer survivors versus 17/56 (30%) controls (P=.01). Cancer survivors had a higher baseline and maximum standing heart rate (both P<.001) and a more rapid onset of significant OT (P=.005). No significant difference in scores on self-report measures was found between cancer survivors with or without OT.
  
  
  CONCLUSIONS
  This study provides preliminary evidence of a higher rate of orthostatic intolerance in childhood cancer survivors. Further study is warranted to better define whether this is a modifiable risk factor for fatigue in this population, and how orthostatic intolerance interacts with other known risk factors for lowered quality of life.
authors: Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands.
authors: Annelinde
authors: A
authors: Terlou
authors: Kathy
authors: K
authors: Ruble
authors: Anne F
authors: AF
authors: Stapert
authors: Ho-Choong
authors: HC
authors: Chang
authors: Peter C
authors: PC
authors: Rowe
authors: Cindy L
authors: CL
authors: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D005221:Fatigue / Q000209:etiology; D005260:Female; D006304:Health Status; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology*; D011187:Posture; D011788:Quality of Life; D017741:Survivors; D013610:Tachycardia / Q000209:etiology*