Wagner C, Isenmann S, Ringendahl H, Haensch C-A
Klinik für Gefäßchirurgie, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, Berlin.
Fortschr Neurol Psychiatr. 2012 Aug;80(8):458-62. doi: 10.1055/s-0031-1299106. Epub 2012 Jun 12.
The postural tachycardia syndrome (POTS) is a condition of the autonomic nervous system with symptoms of orthostatic intolerance. In POTS patients, orthostatic stress leads to an overshoot of heart rate increase without a fall in blood pressure. The purpose of this study is to distinguish between anxiety disorders and anxiety as a concomitant phenomenon of orthostatic stress.
50 patients fulfilling the diagnostic criteria (orthostatic symptoms, heart rate increase of > 30 bpm or up to > 120 bpm by testing with tilt-table) were included. The study design included a thorough medical history as well as standardised questionnaires about anxiety.
The average heart rate increase was 36 bpm after ten minutes of standing and 42 bpm after maximal standing time (max. 45 minutes). POTS patients scored significantly higher than a comparison group in a range of anxiety disorders by using anxiety questionnaires like "Beck Angst-Inventar" (BAI) and trait test of "State-Traits-Angstinventar" which include autonomic items. When questionnaires were used that exclude autonomic items (anxiety sensitivity index: ASI; Interaktions-Angst-Fragebogen: IAF) there was no difference.
POTS patients do not exhibit signals of anxiety disorders more often than control groups, provided that questionnaires without autonomic items are used.
体位性心动过速综合征（POTS）是一种自主神经系统疾病，伴有体位性不耐受症状。在POTS患者中，体位性应激会导致心率过度增加而血压不降。本研究的目的是区分焦虑症与作为体位性应激伴随现象的焦虑。
纳入50例符合诊断标准（体位性症状，通过倾斜试验心率增加>30次/分钟或最高>120次/分钟）的患者。研究设计包括详细的病史以及关于焦虑的标准化问卷。
站立十分钟后平均心率增加36次/分钟，最大站立时间（最长45分钟）后为42次/分钟。通过使用“贝克焦虑量表”（BAI）等焦虑问卷以及包含自主神经项目的“状态-特质焦虑量表”的特质测试，POTS患者在一系列焦虑症中的得分显著高于对照组。当使用排除自主神经项目的问卷（焦虑敏感性指数：ASI；互动焦虑问卷：IAF）时，没有差异。
如果使用不包含自主神经项目的问卷，POTS患者出现焦虑症信号的频率并不比对照组更高。
