Malmö POTS symptom score : Assessing symptom burden in postural orthostatic tachycardia syndrome
(2023) In Journal of Internal Medicine 293(1). p.91-99- Abstract
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a common cardiovascular autonomic disorder characterized by excessive heart rate (HR) increase on standing and symptoms of orthostatic intolerance, posing significant limitations on functional capacity. No objective tool exists to classify symptom burden in POTS.
METHODS: We conducted a case-control study in 62 POTS patients and 50 healthy controls to compare symptom burden between groups using the newly developed, self-rating, 12-item, Malmö POTS Score (MAPS; 0-10 per item, total range 0-120) based on patients own perception of symptoms through visual analogue scale assessment. We have also explored correlations between symptom severity assessed by MAPS, basic... (More)
BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a common cardiovascular autonomic disorder characterized by excessive heart rate (HR) increase on standing and symptoms of orthostatic intolerance, posing significant limitations on functional capacity. No objective tool exists to classify symptom burden in POTS.
METHODS: We conducted a case-control study in 62 POTS patients and 50 healthy controls to compare symptom burden between groups using the newly developed, self-rating, 12-item, Malmö POTS Score (MAPS; 0-10 per item, total range 0-120) based on patients own perception of symptoms through visual analogue scale assessment. We have also explored correlations between symptom severity assessed by MAPS, basic clinical parameters and postural haemodynamic changes.
RESULTS: POTS patients showed significantly higher total MAPS score (78 ± 20 vs. 14 ± 12, p < 0.001), higher baseline systolic blood pressure (BP), diastolic BP and HR (p < 0.001) compared with healthy controls. The most prominent symptoms in POTS were palpitations, fatigue and concentration difficulties. Haemodynamic parameters on standing were significantly correlated with palpitations in POTS after adjustment for age and sex (lower systolic and diastolic BP, and higher HR) (p < 0.001 for all). Orthostatic HR was significantly associated with concentration difficulties and total MAPS score. The optimal cut-point value of MAPS to differentiate POTS and healthy controls was ≥42 (sensitivity, 97%; specificity, 98%).
CONCLUSIONS: Symptom severity, as assessed by MAPS score, is fivefold higher in POTS compared with healthy individuals. The new MAPS score can be useful as a semiquantitative system to assess symptom burden, monitor disease progression and evaluate pre-test likelihood of disease.
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- author
- Spahic, Jasmina Medic LU ; Hamrefors, Viktor LU ; Johansson, Madeleine LU ; Ricci, Fabrizio LU ; Melander, Olle LU ; Sutton, Richard LU and Fedorowski, Artur LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- POTS, Symptom assessment, Syncope, postural orthostatic tachycardia syndrome, score, Symptom burden
- in
- Journal of Internal Medicine
- volume
- 293
- issue
- 1
- pages
- 9 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85138081022
- pmid:36111700
- ISSN
- 1365-2796
- DOI
- 10.1111/joim.13566
- language
- English
- LU publication?
- yes
- additional info
- © 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.
- id
- b468ccb2-8208-4dc7-a1aa-7683f45ce1b6
- date added to LUP
- 2022-09-22 12:27:34
- date last changed
- 2024-09-07 02:52:04
@article{b468ccb2-8208-4dc7-a1aa-7683f45ce1b6, abstract = {{<p>BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is a common cardiovascular autonomic disorder characterized by excessive heart rate (HR) increase on standing and symptoms of orthostatic intolerance, posing significant limitations on functional capacity. No objective tool exists to classify symptom burden in POTS.</p><p>METHODS: We conducted a case-control study in 62 POTS patients and 50 healthy controls to compare symptom burden between groups using the newly developed, self-rating, 12-item, Malmö POTS Score (MAPS; 0-10 per item, total range 0-120) based on patients own perception of symptoms through visual analogue scale assessment. We have also explored correlations between symptom severity assessed by MAPS, basic clinical parameters and postural haemodynamic changes.</p><p>RESULTS: POTS patients showed significantly higher total MAPS score (78 ± 20 vs. 14 ± 12, p < 0.001), higher baseline systolic blood pressure (BP), diastolic BP and HR (p < 0.001) compared with healthy controls. The most prominent symptoms in POTS were palpitations, fatigue and concentration difficulties. Haemodynamic parameters on standing were significantly correlated with palpitations in POTS after adjustment for age and sex (lower systolic and diastolic BP, and higher HR) (p < 0.001 for all). Orthostatic HR was significantly associated with concentration difficulties and total MAPS score. The optimal cut-point value of MAPS to differentiate POTS and healthy controls was ≥42 (sensitivity, 97%; specificity, 98%).</p><p>CONCLUSIONS: Symptom severity, as assessed by MAPS score, is fivefold higher in POTS compared with healthy individuals. The new MAPS score can be useful as a semiquantitative system to assess symptom burden, monitor disease progression and evaluate pre-test likelihood of disease.</p>}}, author = {{Spahic, Jasmina Medic and Hamrefors, Viktor and Johansson, Madeleine and Ricci, Fabrizio and Melander, Olle and Sutton, Richard and Fedorowski, Artur}}, issn = {{1365-2796}}, keywords = {{POTS; Symptom assessment; Syncope; postural orthostatic tachycardia syndrome; score; Symptom burden}}, language = {{eng}}, number = {{1}}, pages = {{91--99}}, publisher = {{Wiley-Blackwell}}, series = {{Journal of Internal Medicine}}, title = {{Malmö POTS symptom score : Assessing symptom burden in postural orthostatic tachycardia syndrome}}, url = {{http://dx.doi.org/10.1111/joim.13566}}, doi = {{10.1111/joim.13566}}, volume = {{293}}, year = {{2023}}, }