Habek Mario, Ruška Berislav, Crnošija Luka, Adamec Ivan, Junaković Anamari, Krbot Skorić Magdalena
Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia.
Department of Neurology, University Hospital Center Zagreb, Referral Center for Autonomic Nervous System Disorders, Zagreb, Croatia.
J Clin Neurol. 2019 Apr;15(2):205-210. doi: 10.3988/jcn.2019.15.2.205. Epub 2019 Mar 11.
The aim of this study was to determine the effect of food intake on the heart rate (HR) in postural orthostatic tachycardia syndrome (POTS).
The following five-phase protocol was applied to 41 subjects who had a sustained HR increment of ≥30 beats/min within 10 min of standing in an initial tilt-table test: 1) 10-min supine phase, 2) 10-min 70°-tilted phase, 3) ingestion of 400 mL of Nutridrink Multi Fibre®, 4) 45-min supine phase, and 5) 10-min 70°-tilted phase. Subjects were divided into four groups: A) difference in HR for standing vs. supine (ΔHR) before the meal of ≥30 beats/min (=13), B) ΔHR <30 beats/min before the meal but ≥30 beats/min after the meal (=12), and C) ΔHR <30 beats/min both before and after the meal (=16). Group D consisted of 10 healthy subjects.
Before the meal, ΔHR was significantly higher in group A than in all of the other groups, and in group B than in group D (<0.001). After the meal, ΔHR was significantly higher in groups A and B (<0.001 and <0.0001, respectively). When we pooled patients (according to their symptoms) from group A and B into a POTS group and from group C and D into a non-POTS group, an increase in HR of 25 beats/min before the meal had a sensitivity of 92.0% and a specificity of 80.8%. After the meal, an increase in HR of 30 beats/min had a sensitivity of 96.0% and a specificity of 96.2%.
Food intake can significantly alter the results of the tilt-table test and so should be taken into account when diagnosing POTS.
本研究旨在确定食物摄入对体位性直立性心动过速综合征（POTS）患者心率（HR）的影响。
对41名在初始倾斜试验站立10分钟内心率持续增加≥30次/分钟的受试者采用以下五阶段方案：1）10分钟仰卧位阶段，2）10分钟70°倾斜阶段，3）摄入400 mL营养饮料多纤维型，4）45分钟仰卧位阶段，5）10分钟70°倾斜阶段。受试者分为四组：A组（饭前站立与仰卧时的心率差值（ΔHR）≥30次/分钟，n = 13），B组（饭前ΔHR < 30次/分钟但饭后≥30次/分钟，n = 12），C组（饭前和饭后ΔHR均< 30次/分钟，n = 16）。D组由10名健康受试者组成。
饭前，A组的ΔHR显著高于所有其他组，B组高于D组（P < 0.001）。饭后，A组和B组的ΔHR显著更高（分别为P < 0.001和P < 0.0001）。当我们将A组和B组的患者（根据其症状）合并为POTS组，将C组和D组合并为非POTS组时，饭前心率增加25次/分钟的敏感性为92.0%，特异性为80.8%。饭后，心率增加30次/分钟的敏感性为96.0%，特异性为96.2%。
食物摄入可显著改变倾斜试验结果，因此在诊断POTS时应予以考虑。
