Exercise performance in adolescents with autonomic dysfunction.
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).


METHODS
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.
Burkhardt
Barbara E U
BE
Department of Pediatric Cardiology and Congenital Heart Disease, University Medical Center Freiburg, Freiburg, Germany.
Fischer
Phil R
PR
Brands
Chad K
CK
Porter
Co-burn J
CB
Weaver
Amy L
AL
Yim
Paul J
PJ
Pianosi
Paolo T
PT
D000293:Adolescent; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D018667:Tilt-Table Test