Pooling in chronic orthostatic intolerance: arterial vasoconstrictive but not venous compliance defects.

Abstract:

BACKGROUND:Orthostatic intolerance is characterized by postural tachycardia syndrome (POTS) with exaggerated tachycardia, orthostatic symptoms, and "pooling" (which comprises acrocyanosis and dependent edema when upright). My colleagues and I tested the hypothesis that pooling results from increased venous compliance in POTS patients. METHODS AND RESULTS:Fifteen patients aged 13 to 19 years were compared with 11 healthy, age-matched controls. The POTS group was divided into patients with high venous pressure (P(v)>20 mm Hg) and normal P(v) on the basis of resting supine P(v) obtained in previous work. Subjects were studied using strain gauge plethysmography to measure blood flow, P(v), and the venous compliance volume-pressure relation while supine and during incremental head-up tilt testing at -10 degrees, 0 degrees, 20 degrees, and 35 degrees. Volume-pressure relations of controls and POTS patients with normal P(v) and high P(v) were not different and were unchanged by orthostasis. Supine leg peripheral resistance was greater than control resistance in patients with high P(v) (54+/-9 versus 30+/-6 mm Hg x mL(-1) x 100 mL(-1) x min(-1)) and less than control resistance in patients with normal P(v) (17+/-2 mm Hg x mL(-1) x 100 mL(-1) x min(-1)). On upright tilt, resistance decreased in high P(v) to approximate resistance in normal P(v). Resistance in controls increased throughout tilt. Leg P(v) increased in patients with normal P(v) and in controls but remained unchanged in the high P(v) group. CONCLUSIONS:The findings suggest that pooling in POTS is due to blunted arterial vasoconstriction, which produces passive redistribution of blood within peripheral venous capacitance beds. Venous compliance in POTS is similar to that in control subjects.

journal_name

Circulation

journal_title

Circulation

authors

Stewart JM

doi

10.1161/01.cir.0000016348.55378.c4

subject

Has Abstract

pub_date

2002-05-14 00:00:00

pages

2274-81

issue

19

eissn

0009-7322

issn

1524-4539

journal_volume

105

pub_type

临床试验,杂志文章
  • Serum antibodies against Chlamydia pneumoniae outer membrane protein cross-react with the heavy chain of immunoglobulin in the wall of abdominal aortic aneurysms.

    abstract:BACKGROUND:Chlamydia pneumoniae (Cp) has been demonstrated in arteries and abdominal aortic aneurysms (AAAs). However, the validity of the methods used is questioned, and antibiotic treatment trials have thus far shown disappointing results. Nevertheless, antibodies against the Cp outer membrane proteins (OMPs) have be...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000127772.58427.7E

    authors: Lindholt JS,Støvring J,Østergaard L,Urbonavicius S,Henneberg EW,Honoré B,Vorum H

    更新日期:2004-05-04 00:00:00

  • Fish-rich diet, leptin, and body mass.

    abstract:BACKGROUND:Leptin has been implicated in cardiovascular disease. A diet rich in fish has been associated with decreased cardiac and vascular risk. METHODS AND RESULTS:We examined the relationship between diet and leptin in 2 related homogeneous African tribal populations of Tanzania. One tribe consumes freshwater fish...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000025241.01418.4d

    authors: Winnicki M,Somers VK,Accurso V,Phillips BG,Puato M,Palatini P,Pauletto P

    更新日期:2002-07-16 00:00:00

  • Mortality after 16 years for participants randomized to the Multiple Risk Factor Intervention Trial.

    abstract:BACKGROUND:A mortality follow-up of 12,866 men was conducted 16 years after randomization to special intervention (SI) or usual care (UC) groups of the Multiple Risk Factor Intervention Trial to assess the long-term effect of cardiovascular risk factor intervention on coronary heart disease (CHD), cardiovascular death ...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.94.5.946

    authors:

    更新日期:1996-09-01 00:00:00

  • Crucial role of endogenous interleukin-10 production in myocardial ischemia/reperfusion injury.

    abstract:BACKGROUND:The anti-inflammatory cytokine interleukin-10 (IL-10) has been detected in the plasma of patients with myocardial ischemia/reperfusion. The aim of our study was to investigate the role of endogenously produced IL-10 in myocardial ischemia/reperfusion. METHODS AND RESULTS:In the present study, we used wild-t...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.9.1019

    authors: Yang Z,Zingarelli B,Szabó C

    更新日期:2000-03-07 00:00:00

  • Vitamin C augments the inotropic response to dobutamine in humans with normal left ventricular function.

    abstract:BACKGROUND:We studied the effect of an antioxidant, the intracoronary infusion of vitamin C, on basal and dobutamine-stimulated left ventricular (LV) contractility. METHODS AND RESULTS:Nineteen patients with normal ventricular function participated in this study. A micromanometer-tipped catheter was inserted into the ...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.103.6.826

    authors: Mak S,Newton GE

    更新日期:2001-02-13 00:00:00

  • Post-cardiopulmonary bypass pulmonary hypertension in lambs with increased pulmonary blood flow. A role for endothelin 1.

    abstract:BACKGROUND:After cardiopulmonary bypass (CPB), pulmonary hypertension and its associated increased vascular reactivity are a major source of morbidity, particularly for children with increased pulmonary blood flow. Although post-CPB pulmonary hypertension is well described, its mechanisms remain incompletely understood...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.95.4.1054

    authors: Reddy VM,Hendricks-Munoz KD,Rajasinghe HA,Petrossian E,Hanley FL,Fineman JR

    更新日期:1997-02-18 00:00:00

  • Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association.

    abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of death in the United States and is responsible for 17% of national health expenditures. As the population ages, these costs are expected to increase substantially. METHODS AND RESULTS:To prepare for future cardiovascular care needs, the American Heart Asso...

    journal_title:Circulation

    pub_type: 共识发展会议,杂志文章

    doi:10.1161/CIR.0b013e31820a55f5

    authors: Heidenreich PA,Trogdon JG,Khavjou OA,Butler J,Dracup K,Ezekowitz MD,Finkelstein EA,Hong Y,Johnston SC,Khera A,Lloyd-Jones DM,Nelson SA,Nichol G,Orenstein D,Wilson PW,Woo YJ,American Heart Association Advocacy Coordinating

    更新日期:2011-03-01 00:00:00

  • Role of functional block extension in lesion-related atrial flutter.

    abstract:BACKGROUND:A line of block in the right atrium (RA) between the venae cavae is necessary to obtain classic atrial flutter (AFL). We tested the hypothesis that the location of that line of block would determine whether the AFL reentrant circuit would be due to single-loop reentry or figure-of-8 reentry. METHODS AND RES...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.103.7.1025

    authors: Tomita Y,Matsuo K,Sahadevan J,Khrestian CM,Waldo AL

    更新日期:2001-02-20 00:00:00

  • Effective regurgitant orifice area by the color Doppler flow convergence method for evaluating the severity of chronic aortic regurgitation. An animal study.

    abstract:BACKGROUND:The aim of the present study was to evaluate dynamic changes in aortic regurgitant (AR) orifice area with the use of calibrated electromagnetic (EM) flowmeters and to validate a color Doppler flow convergence (FC) method for evaluating effective AR orifice area and regurgitant volume. METHODS AND RESULTS:In...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.93.3.594

    authors: Shiota T,Jones M,Yamada I,Heinrich RS,Ishii M,Sinclair B,Holcomb S,Yoganathan AP,Sahn DJ

    更新日期:1996-02-01 00:00:00

  • Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial.

    abstract:BACKGROUND:Chronic heart failure remains a major cause of mortality and morbidity. The role of antithrombotic therapy in patients with chronic heart failure has long been debated. The objective of this study was to determine the optimal antithrombotic agent for heart failure patients with reduced ejection fractions who...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.108.801753

    authors: Massie BM,Collins JF,Ammon SE,Armstrong PW,Cleland JG,Ezekowitz M,Jafri SM,Krol WF,O'Connor CM,Schulman KA,Teo K,Warren SR,WATCH Trial Investigators.

    更新日期:2009-03-31 00:00:00

  • Magnetic resonance--guided coronary artery stent placement in a swine model.

    abstract:BACKGROUND:Magnetic resonance (MR)--guided coronary artery stent placement is a challenging vascular intervention because of the small size of the coronary arteries combined with incessant motion during the respiratory and cardiac cycles. These obstacles necessitate higher temporal and higher spatial resolution real-ti...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/hc0702.104165

    authors: Spuentrup E,Ruebben A,Schaeffter T,Manning WJ,Günther RW,Buecker A

    更新日期:2002-02-19 00:00:00

  • Repeat coronary revascularization after coronary artery bypass surgery in older adults: the Society of Thoracic Surgeons' national experience, 1991-2007.

    abstract:BACKGROUND:A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era. METHODS AND RESULTS:We included patients ≥65 yea...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.113.001882

    authors: Fosbøl EL,Zhao Y,Shahian DM,Grover FL,Edwards FH,Peterson ED

    更新日期:2013-04-23 00:00:00

  • Tumor necrosis factor-alpha-converting enzyme and tumor necrosis factor-alpha in human dilated cardiomyopathy.

    abstract:BACKGROUND:Tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of dilated cardiomyopathy (DCM). TNF-alpha-converting enzyme (TACE) has recently been purified and its complementary DNA cloned. The expression of TACE results in the production of a functional enzyme that has precursor TNF-alpha...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.25.3260

    authors: Satoh M,Nakamura M,Saitoh H,Satoh H,Maesawa C,Segawa I,Tashiro A,Hiramori K

    更新日期:1999-06-29 00:00:00

  • Adenoviral gene transfer of fortilin attenuates neointima formation through suppression of vascular smooth muscle cell proliferation and migration.

    abstract:BACKGROUND:Fortilin, a recently characterized nuclear antiapoptotic factor structurally distinct from inhibitor of apoptosis proteins (IAPs) and Bcl-2 family member proteins, has been suggested to be involved in cell survival and regulation of apoptosis within the cardiovascular system. In this continued investigation,...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000047675.86603.eb

    authors: Tulis DA,Mnjoyan ZH,Schiesser RL,Shelat HS,Evans AJ,Zoldhelyi P,Fujise K

    更新日期:2003-01-07 00:00:00

  • The QT interval throughout the first 6 months of life: a prospective study.

    abstract::A prospective electrocardiographic study was designed to establish baseline values for electrocardiographic measurements, with specific reference to the QT interval during infancy, and to test the "QT hypothesis" for the sudden infant death syndrome (SIDS). In this ongoing study, ECGs are recorded on the fourth day of...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.66.3.496

    authors: Schwartz PJ,Montemerlo M,Facchini M,Salice P,Rosti D,Poggio G,Giorgetti R

    更新日期:1982-09-01 00:00:00

  • Intravascular thrombosis after hypoxia-induced pulmonary hypertension: regulation by cyclooxygenase-2.

    abstract:BACKGROUND:Pulmonary hypertension induced by chronic hypoxia is characterized by thickening of pulmonary artery walls, elevated pulmonary vascular resistance, and right-heart failure. Prostacyclin analogues reduce pulmonary pressures in this condition; raising the possibility that cycloxygenase-2 (COX-2) modulates the ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000145613.01188.0B

    authors: Pidgeon GP,Tamosiuniene R,Chen G,Leonard I,Belton O,Bradford A,Fitzgerald DJ

    更新日期:2004-10-26 00:00:00

  • Red wine inhibits monocyte chemotactic protein-1 expression and modestly reduces neointimal hyperplasia after balloon injury in cholesterol-Fed rabbits.

    abstract:BACKGROUND:Wine consumption decreases the risk of myocardial infarction. Intimal hyperplasia contributes to restenosis after angioplasty. Local ethanol delivery inhibits intimal hyperplasia after balloon injury in rabbit iliac and pig coronary arteries. The effects of wine consumption on intimal response and monocyte c...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.100.22.2254

    authors: Feng AN,Chen YL,Chen YT,Ding YZ,Lin SJ

    更新日期:1999-11-30 00:00:00

  • Randomized trial of subcutaneous low-molecular-weight heparin CY 216 (Fraxiparine) compared with intravenous unfractionated heparin in the curative treatment of submassive pulmonary embolism. A dose-ranging study.

    abstract:BACKGROUND:We compared the efficacy and safety of different dosages of a low-molecular-weight heparin, CY 216 D (Fraxiparine), in the treatment of submassive pulmonary embolism with unfractionated heparin in a prospective, randomized, dose-finding study. METHODS AND RESULTS:The primary outcome was the evolution of pul...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.85.4.1380

    authors: Théry C,Simonneau G,Meyer G,Hélénon O,Bridey F,Armagnac C,d'Azemar P,Coquart JP

    更新日期:1992-04-01 00:00:00

  • Simultaneous autologous transplantation of cocultured mesenchymal stem cells and skeletal myoblasts improves ventricular function in a murine model of Chagas disease.

    abstract:BACKGROUND:Cellular transplantation is emerging as a promising strategy for the treatment of postinfarction ventricular dysfunction. Whether its beneficial effects can be extended to other cardiomyopathies remains an unexplored question. We evaluated the histological and functional effects of simultaneous autologous tr...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.105.000646

    authors: Guarita-Souza LC,Carvalho KA,Woitowicz V,Rebelatto C,Senegaglia A,Hansen P,Miyague N,Francisco JC,Olandoski M,Faria-Neto JR,Brofman P

    更新日期:2006-07-04 00:00:00

  • Improving Assessment of Drug Safety Through Proteomics: Early Detection and Mechanistic Characterization of the Unforeseen Harmful Effects of Torcetrapib.

    abstract:BACKGROUND:Early detection of adverse effects of novel therapies and understanding of their mechanisms could improve the safety and efficiency of drug development. We have retrospectively applied large-scale proteomics to blood samples from ILLUMINATE (Investigation of Lipid Level Management to Understand its Impact in...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.117.028213

    authors: Williams SA,Murthy AC,DeLisle RK,Hyde C,Malarstig A,Ostroff R,Weiss SJ,Segal MR,Ganz P

    更新日期:2018-03-06 00:00:00

  • Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the Framingham Offspring Population.

    abstract:BACKGROUND:Fibrinogen has been identified as an independent risk factor for cardiovascular disease and associated with traditional cardiovascular risk factors. Also, the role of elevated fibrinogen in thrombosis suggests that it may be on the causal pathway for certain risk factors to exert their effect. These associat...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.14.1634

    authors: Stec JJ,Silbershatz H,Tofler GH,Matheney TH,Sutherland P,Lipinska I,Massaro JM,Wilson PF,Muller JE,D'Agostino RB Sr

    更新日期:2000-10-03 00:00:00

  • Spontaneous occurrence of symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia in untreated patients.

    abstract:BACKGROUND:Ambulatory outpatients (n = 150) with a history of paroxysmal supraventricular arrhythmia were studied to establish the characteristics of the first recurrence of symptomatic tachycardia (time to first recurrence, heart rate during tachycardia, and observed rhythm that was regular versus irregular) when no a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.87.4.1114

    authors: Clair WK,Wilkinson WE,McCarthy EA,Page RL,Pritchett EL

    更新日期:1993-04-01 00:00:00

  • Short- and intermediate-term clinical outcomes from direct myocardial laser revascularization guided by biosense left ventricular electromechanical mapping.

    abstract:BACKGROUND:Direct myocardial revascularization (DMR) has been examined as an alternative treatment for patients with chronic refractory myocardial ischemic syndromes who are not candidates for conventional coronary revascularization. Methods and Results-We used left ventricular electromagnetic guidance in 77 patients w...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.10.1120

    authors: Kornowski R,Baim DS,Moses JW,Hong MK,Laham RJ,Fuchs S,Hendel RC,Wallace D,Cohen DJ,Bonow RO,Kuntz RE,Leon MB

    更新日期:2000-09-05 00:00:00

  • Plaque volume and occurrence and location of periprocedural myocardial necrosis after percutaneous coronary intervention: insights from delayed-enhancement magnetic resonance imaging, thrombolysis in myocardial infarction myocardial perfusion grade analys

    abstract:BACKGROUND:Myocardial necrosis can occur during percutaneous coronary intervention (PCI) despite optimal adjunctive pharmacology and careful technique. We investigated the mechanisms of procedural infarction using angiographic analysis, intravascular ultrasound, and delayed-enhancement magnetic resonance imaging. METH...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/CIRCULATIONAHA.105.593210

    authors: Porto I,Selvanayagam JB,Van Gaal WJ,Prati F,Cheng A,Channon K,Neubauer S,Banning AP

    更新日期:2006-08-15 00:00:00

  • Cardiac hypertrophy and failure--a disease of adaptation. Modifications in membrane proteins provide a molecular basis for arrhythmogenicity.

    abstract::Cardiac hypertrophy is the physiological adaptation of the heart to chronic mechanical overload. Cardiac failure indicates the limits of the process. Cardiac hypertrophy is only one example of biological adaptation and results from the induction of several changes in gene expression, mostly of the fetal type, includin...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:

    authors: Moalic JM,Charlemagne D,Mansier P,Chevalier B,Swynghedauw B

    更新日期:1993-05-01 00:00:00

  • Sevelamer prevents uremia-enhanced atherosclerosis progression in apolipoprotein E-deficient mice.

    abstract:BACKGROUND:The novel phosphate binder sevelamer has been shown to prevent the progression of aortic and coronary calcification in uremic patients. Whether it also decreases the progression of atheromatous plaques is unknown. The aim of our study was to examine the effect of sevelamer administration on the development o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA105.541854

    authors: Phan O,Ivanovski O,Nguyen-Khoa T,Mothu N,Angulo J,Westenfeld R,Ketteler M,Meert N,Maizel J,Nikolov IG,Vanholder R,Lacour B,Drüeke TB,Massy ZA

    更新日期:2005-11-01 00:00:00

  • Endothelins and endothelin receptor antagonists: therapeutic considerations for a novel class of cardiovascular drugs.

    abstract::The 21-amino acid peptide endothelin-1 (ET-1) is the predominant isoform of the endothelin peptide family, which includes ET-2, ET-3, and ET-4. It exerts various biological effects, including vasoconstriction and the stimulation of cell proliferation in tissues both within and outside of the cardiovascular system. ET-...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.102.19.2434

    authors: Lüscher TF,Barton M

    更新日期:2000-11-07 00:00:00

  • L-arginine supplementation in peripheral arterial disease: no benefit and possible harm.

    abstract:BACKGROUND:L-arginine is the precursor of endothelium-derived nitric oxide, an endogenous vasodilator. L-arginine supplementation improves vascular reactivity and functional capacity in peripheral arterial disease (PAD) in small, short-term studies. We aimed to determine the effects of long-term administration of L-arg...

    journal_title:Circulation

    pub_type: 杂志文章,随机对照试验

    doi:10.1161/CIRCULATIONAHA.106.683656

    authors: Wilson AM,Harada R,Nair N,Balasubramanian N,Cooke JP

    更新日期:2007-07-10 00:00:00

  • Enalapril reduces the incidence of diabetes in patients with chronic heart failure: insight from the Studies Of Left Ventricular Dysfunction (SOLVD).

    abstract:BACKGROUND:Diabetes mellitus is a predictor of morbidity and mortality in patients with heart failure. The effect of angiotensin-converting enzyme (ACE) inhibitors on the prevention of diabetes in patients with left ventricular dysfunction is unknown. The aim of this retrospective study was to assess the effect of the ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000054611.89228.92

    authors: Vermes E,Ducharme A,Bourassa MG,Lessard M,White M,Tardif JC,Studies Of Left Ventricular Dysfunction.

    更新日期:2003-03-11 00:00:00

  • An oligosaccharide sialyl-Lewis(x) analogue does not reduce myocardial infarct size after ischemia and reperfusion in dogs.

    abstract:BACKGROUND:Polymorphonuclear leukocytes, particularly neutrophils, are important mediators of ischemia/reperfusion-induced myocardial and coronary vascular injury. The selectin family of glycoprotein receptors mediates neutrophil "rolling," a loose, transient adhesion to the coronary endothelium that precedes the firme...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.94.3.542

    authors: Gill EA,Kong Y,Horwitz LD

    更新日期:1996-08-01 00:00:00