Downregulation of growth hormone in postural orthostatic tachycardia syndrome: insights from the SYSTEMA cohort
Johansson, Madeleine LU
; Schulte, Janin
; Ricci, Fabrizio
LU
; Persson, M
; Sutton, Richard
; Hamrefors, Viktor
LU
and Fedorowski, Artur
LU
(2020)
In European Heart Journal, Supplement
41(Issue Supplement_2).
- Abstract
- Background
Postural orthostatic tachycardia syndrome (POTS) is a variant of cardiovascular autonomic disorder occurring predominantly in young women. POTS is characterized by an excessive heart rate increase when assuming upright posture accompanied by symptoms of orthostatic intolerance. The pathophysiology of POTS has not been fully established and is believed to be multifactorial.
Purpose
We aimed to investigate the alterations in circulating growth hormone level in POTS.
Methods
We conducted an age-matched case-control study enrolling 42 patients with POTS (age 31±9 years; 36 women) verified by positive head-up tilt testing and cardiovascular autonomic tests, and 46 controls (32±9 years; 35 women) with... (More) - Background
Postural orthostatic tachycardia syndrome (POTS) is a variant of cardiovascular autonomic disorder occurring predominantly in young women. POTS is characterized by an excessive heart rate increase when assuming upright posture accompanied by symptoms of orthostatic intolerance. The pathophysiology of POTS has not been fully established and is believed to be multifactorial.
Purpose
We aimed to investigate the alterations in circulating growth hormone level in POTS.
Methods
We conducted an age-matched case-control study enrolling 42 patients with POTS (age 31±9 years; 36 women) verified by positive head-up tilt testing and cardiovascular autonomic tests, and 46 controls (32±9 years; 35 women) with negative active standing test and no history of syncope, orthostatic intolerance and endocrine disease. We measured plasma levels of growth hormone using a high-sensitivity chemiluminescence immunoassay in relation to presence of POTS diagnosis. All study participants completed the validated Orthostatic Hypotension Questionnaire (OHQ), consisting of two components: the symptoms assessment scale (OHSA) and daily activity scale (OHDAS) to evaluate the burden of symptoms. We applied standard statistical tests for group differences. Growth hormone values were log-transformed and standardized before the group comparison.
Results
POTS patients had significantly lower plasma levels of growth hormone (ng/mL) (median=0.53, IQR, 0.10–2.83 vs. median=2.33, IQR, 0.26–7.2, p=0.04) than controls. Levels of growth hormone were reversely related to OHDAS (p=0.049) among POTS patients. Supine heart rate was significantly higher in POTS patients (69.0±11.1 beats/min vs. 63.3±10.8 beats/min, p=0.02), as well as diastolic blood pressure (72.9±9.1 mmHg vs. 69.0±8.5 mmHg, p=0.04). We observed no significant difference in supine systolic blood pressure (116.6±13.3 mmHg vs. 115.2±10.0 mmHg, p=0.60). POTS patients had a significantly higher composite OHQ score than controls (60.0±18.6 vs. 4.2±7.5, p<0.001), as well as OHSA (36.2±10.0 vs. 3.6±6.4, p<0.001) and OHDAS (23.8±9.7 vs. 0.6±1.3, p<0.001).
Conclusion(s)
Our study shows that patients with POTS have significantly reduced plasma levels of circulating growth hormone. Lower growth hormone levels among POTS patients are associated with increased impairment of daily life activities. Further studies are necessary to confirm our findings in the independent populations and explain the mechanisms behind this alteration. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/740bc887-c736-4fda-a19c-462ad385fdfa
- author
- Johansson, Madeleine
LU
; Schulte, Janin
; Ricci, Fabrizio
LU
; Persson, M
; Sutton, Richard
; Hamrefors, Viktor
LU
and Fedorowski, Artur
LU
- organization
- publishing date
- 2020-11-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Heart Journal, Supplement
- volume
- 41
- issue
- Issue Supplement_2
- publisher
- Oxford University Press
- ISSN
- 1520-765X
- DOI
- 10.1093/ehjci/ehaa946.0686
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2020, Oxford University Press
- id
- 740bc887-c736-4fda-a19c-462ad385fdfa
- date added to LUP
- 2020-12-28 13:18:16
- date last changed
- 2023-07-15 02:49:13
@misc{740bc887-c736-4fda-a19c-462ad385fdfa,
abstract = {{Background<br>
Postural orthostatic tachycardia syndrome (POTS) is a variant of cardiovascular autonomic disorder occurring predominantly in young women. POTS is characterized by an excessive heart rate increase when assuming upright posture accompanied by symptoms of orthostatic intolerance. The pathophysiology of POTS has not been fully established and is believed to be multifactorial.<br>
<br>
Purpose<br>
We aimed to investigate the alterations in circulating growth hormone level in POTS.<br>
<br>
Methods<br>
We conducted an age-matched case-control study enrolling 42 patients with POTS (age 31±9 years; 36 women) verified by positive head-up tilt testing and cardiovascular autonomic tests, and 46 controls (32±9 years; 35 women) with negative active standing test and no history of syncope, orthostatic intolerance and endocrine disease. We measured plasma levels of growth hormone using a high-sensitivity chemiluminescence immunoassay in relation to presence of POTS diagnosis. All study participants completed the validated Orthostatic Hypotension Questionnaire (OHQ), consisting of two components: the symptoms assessment scale (OHSA) and daily activity scale (OHDAS) to evaluate the burden of symptoms. We applied standard statistical tests for group differences. Growth hormone values were log-transformed and standardized before the group comparison.<br>
<br>
Results<br>
POTS patients had significantly lower plasma levels of growth hormone (ng/mL) (median=0.53, IQR, 0.10–2.83 vs. median=2.33, IQR, 0.26–7.2, p=0.04) than controls. Levels of growth hormone were reversely related to OHDAS (p=0.049) among POTS patients. Supine heart rate was significantly higher in POTS patients (69.0±11.1 beats/min vs. 63.3±10.8 beats/min, p=0.02), as well as diastolic blood pressure (72.9±9.1 mmHg vs. 69.0±8.5 mmHg, p=0.04). We observed no significant difference in supine systolic blood pressure (116.6±13.3 mmHg vs. 115.2±10.0 mmHg, p=0.60). POTS patients had a significantly higher composite OHQ score than controls (60.0±18.6 vs. 4.2±7.5, p<0.001), as well as OHSA (36.2±10.0 vs. 3.6±6.4, p<0.001) and OHDAS (23.8±9.7 vs. 0.6±1.3, p<0.001).<br>
<br>
Conclusion(s)<br>
Our study shows that patients with POTS have significantly reduced plasma levels of circulating growth hormone. Lower growth hormone levels among POTS patients are associated with increased impairment of daily life activities. Further studies are necessary to confirm our findings in the independent populations and explain the mechanisms behind this alteration.}},
author = {{Johansson, Madeleine and Schulte, Janin and Ricci, Fabrizio and Persson, M and Sutton, Richard and Hamrefors, Viktor and Fedorowski, Artur}},
issn = {{1520-765X}},
language = {{eng}},
month = {{11}},
note = {{Conference Abstract}},
number = {{Issue Supplement_2}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal, Supplement}},
title = {{Downregulation of growth hormone in postural orthostatic tachycardia syndrome: insights from the SYSTEMA cohort}},
url = {{http://dx.doi.org/10.1093/ehjci/ehaa946.0686}},
doi = {{10.1093/ehjci/ehaa946.0686}},
volume = {{41}},
year = {{2020}},
}