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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Pathogenesis and Individualized Treatment for Postural Tachycardia Syndrome in Children
Wen-Rui Xu1, Hong-Fang Jin1, Jun-Bao Du1
1Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Objective:
Postural tachycardia syndrome (POTS) is one of the major causes of orthostatic intolerance in children. We systematically reviewed the pathogenesis and the progress of individualized treatment for POTS in children.
Data Sources:
The data analyzed in this review are mainly from articles included in PubMed and EMBASE.
Study Selection:
The original articles and critical reviews about POTS were selected for this review.
Results:
Studies have shown that POTS might be related to several factors including hypovolemia, high catecholamine status, abnormal local vascular tension, and decreased skeletal muscle pump activity. In addition to exercise training, the first-line treatments mainly include oral rehydration salts, beta-adrenoreceptor blockers, and alpha-adrenoreceptor agonists. However, reports about the effectiveness of various treatments are diverse. By analyzing the patient's physiological indexes and biomarkers before the treatment, the efficacy of medication could be well predicted.
Conclusions:
The pathogenesis of POTS is multifactorial, including hypovolemia, abnormal catecholamine state, and vascular dysfunction. Biomarker-directed individualized treatment is an important strategy for the management of POTS children.
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