NYMC Faculty Publications
Hemodynamic Characteristics of Postural Hyperventilation: POTS with Hyperventilation vs Panic vs Voluntary Hyperventilation
DOI
10.1152/japplphysiol.00377.2018
Journal Title
Journal of Applied Physiology
First Page
1396
Last Page
1403
Document Type
Article
Publication Date
November 2018
Department
Pediatrics
Abstract
Upright hyperventilation occurs in approximately 25% of our patients with postural tachycardia syndrome (POTS). Poikilocapnic hyperventilation alone causes tachycardia. Here we examined changes in respiration and hemodynamics comprising cardiac output (CO), systemic vascular resistance (SVR) and blood pressure (BP) measured during head-up tilt (HUT) in 3 groups: patients with POTS and hyperventilation (POTS-HV), patients with Panic Disorder who hyperventilate (Panic), and healthy controls performing voluntary upright hyperpnea (Voluntary-HV). Though all were comparably tachycardic during hyperventilation, POTS-HV manifested hyperpnea, decreased CO, increased SVR and increased BP during HUT; Panic patients showed both hyperpnea and tachypnea, increased CO and increased SVR as BP increased during HUT; and Voluntary-HV were hyperneic by design and had increased CO, decreased SVR, and decreased BP during upright hyperventilation. Mechanisms of hyperventilation and hemodynamic changes differed among POTS-HV, Panic and Voluntary-HV subjects. We hypothesize that the hyperventilation in POTS is caused by a mechanism involving peripheral chemoreflex sensitization by intermittent ischemic hypoxia.
Recommended Citation
Stewart, J., Pianosi, P., Shaban, M., Terilli, C., Svistunova, M., Visintainer, P., & Medow, M. (2018). Hemodynamic Characteristics of Postural Hyperventilation: POTS with Hyperventilation vs Panic vs Voluntary Hyperventilation. Journal of Applied Physiology, 125 (5), 1396-1403. https://doi.org/10.1152/japplphysiol.00377.2018