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Ascorbate improves circulation in postural tachycardia syndrome.

Julian M Stewart¹, Anthony J Ocon, Marvin S Medow

¹Department of Physiology, New York Medical College, Valhalla, New York 10532, USA. julian_stewart@nymc.edu

American Journal of Physiology. Heart and Circulatory Physiology

|May 31, 2011

Summary

Low flow postural tachycardia syndrome (LFP) involves vasoconstriction and reduced nitric oxide (NO). Ascorbic acid improved NO-dependent skin blood flow and normalized vascular resistance in LFP patients.

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A Rapid and Specific Microplate Assay for the Determination of Intra- and Extracellular Ascorbate in Cultured Cells

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Published on: April 11, 2014

Area of Science:

Cardiovascular Physiology
Medical Science

Background:

Low flow postural tachycardia syndrome (LFP) is characterized by vasoconstriction, reduced cardiac output, elevated angiotensin II, diminished nitric oxide (NO), and oxidative stress.
These physiological alterations suggest a potential role for impaired NO bioavailability and increased oxidative stress in LFP pathophysiology.

Purpose of the Study:

To investigate whether systemic administration of ascorbate (vitamin C) can enhance cutaneous nitric oxide (NO) bioavailability and alleviate vasoconstriction in patients with LFP.
To assess the systemic hemodynamic effects of ascorbic acid infusion in LFP patients.

Main Methods:

Utilized local cutaneous heating and laser Doppler flowmetry to measure NO-dependent vasodilation (%CVC(max)) in response to intradermal sodium ascorbate.
Employed Finometer, ModelFlow, and venous occlusion plethysmography to evaluate systemic hemodynamics, including cardiac index, peripheral blood flow, and vascular resistance before and after ascorbic acid infusion in LFP patients and controls.

Main Results:

LFP patients exhibited blunted NO-dependent cutaneous vasodilation compared to controls, which was improved by ascorbate.
Systemic ascorbic acid infusion increased cardiac index and peripheral blood flow by 40% in LFP patients.
Ascorbate significantly reduced elevated peripheral vascular resistance and normalized reduced calf capacitance and venous resistance in LFP patients.

Conclusions:

The findings provide experimental evidence that oxidative stress and reduced NO bioavailability contribute to the vasoconstriction and venoconstriction observed in low flow postural tachycardia syndrome.
Systemic ascorbate administration demonstrates potential therapeutic benefits by improving vascular function in LFP.