title: The complexity of diagnosing postural orthostatic tachycardia syndrome: influence of the diurnal variability.
abstract: We investigated how the diagnosis of postural orthostatic tachycardia syndrome (POTS) would be changed due to diurnal variability in orthostatic tachycardia. The orthostatic vital sign test was administered to each patient twice, in the afternoon of the day of admission and the next morning (n = 113). Forty-six patients were diagnosed with POTS, and the remaining 67 patients were assigned to non-POTS group. Heart rate increments after standing were larger in the morning than in the afternoon in every group (all P < .001). Among the POTS patients, 82.6% fulfilled the diagnostic criteria for POTS in the morning and 52.2% in the afternoon. Most POTS group (65.2%) displayed normal result on single orthostatic vital sign test. Orthostatic intolerance symptoms were provoked in only 45.7% of the POTS patients, more frequently in the morning. In conclusion, diurnal variability in hemodynamic parameters and provoked symptoms significantly challenged the diagnosis of POTS.
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neurology, EwhaWomans University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.
authors: Jangsup
authors: J
authors: Moon
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Han Sang
authors: HS
authors: Lee
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Jung-Ick
authors: JI
authors: Byun
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Jun-Sang
authors: JS
authors: Sunwoo
authors: Department of Neurology, CHA Bundang Medical Center, CHA University, Seoungnam, Republic of Korea.
authors: Jung-Won
authors: JW
authors: Shin
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Jung-Ah
authors: JA
authors: Lim
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Tae-Joon
authors: TJ
authors: Kim
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Yong-Won
authors: YW
authors: Shin
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Keon-Joo
authors: KJ
authors: Lee
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Daejong
authors: D
authors: Jeon
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Keun-Hwa
authors: KH
authors: Jung
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Soon-Tae
authors: ST
authors: Lee
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors: Ki-Young
authors: KY
authors: Jung
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: stemcell.snu@gmail.com.
authors: Kon
authors: K
authors: Chu
authors: Department of Neurology, Laboratory for Neurotherapeutics, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Program in Neuroscience, Neuroscience Research Institute of Seoul National University Medical Research Council, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: sangkun2923@gmail.com.
authors: Sang Kun
authors: SK
authors: Lee
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D054972:Postural Orthostatic Tachycardia Syndrome / Q000175:diagnosis*; D011187:Posture; D013564:Sympathetic Nervous System / Q000503:physiopathology*
keywords: Postural tachycardia syndrome; diurnal variability; orthostatic hypotension; orthostatic intolerance; orthostatic tachycardia