Bourne Kate M, Hall Juliette, Stiles Lauren E, Sheldon Robert S, Shibao Cyndya A, Okamoto Luis E, Garland Emily M, Gamboa Alfredo C, Peltier Amanda, Diedrich Andre, Biaggioni Italo, Robertson David, Raj Satish R
Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Dysautonomia International, East Moriches, New York, USA.
CJC Open. 2021 Sep 4;3(12 Suppl):S44-S52. doi: 10.1016/j.cjco.2021.08.014. eCollection 2021 Dec.
Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance that primarily impacts female patients of childbearing age. The role of sex differences in POTS is not well understood. We sought to identify sex differences in diagnosis, symptoms, comorbidities, and treatments in female and male patients diagnosed with POTS.
A comprehensive survey was designed in partnership by Dysautonomia International (East Moriches, NY) and Vanderbilt University Medical Center (Nashville, TN). Patients were recruited through Dysautonomia International's website and social media channels. The survey was delivered online through a secure research data capture database. Responses were analyzed according to biological sex. Continuous variables are presented as median (25th percentile-75th percentile), and categorical variables are presented as number and proportion of participants.
A total of 8919 patients reported a physician diagnosis of POTS and were included in this analysis. The majority of respondents were female (93.7%). Female and male patients experienced misdiagnosis at similar rates (76.2% vs 74.9%, = 0.5) and saw a similar number of doctors before diagnosis (5 [3-8] vs 5 [3-8], = 0.9). Despite these similarities, diagnostic delay was longer for female, compared with male, patients (1.50 [0.25-5.25] years vs 0.92 [0.08-2.91] years, < 0.001).
Despite the primarily female demographic of POTS patients, female patients experience more challenges with diagnosis than male patients. Increased awareness and recognition of POTS may help to reduce the diagnostic challenges in both female and male patients, and improve treatment and management for individuals living with this debilitating disorder.
体位性直立性心动过速综合征（POTS）是一种慢性直立不耐受形式，主要影响育龄女性患者。POTS中性别差异的作用尚未得到充分理解。我们试图确定诊断为POTS的女性和男性患者在诊断、症状、合并症和治疗方面的性别差异。
由国际自主神经失调协会（纽约州东莫里奇）和范德比尔特大学医学中心（田纳西州纳什维尔）合作设计了一项综合调查。通过国际自主神经失调协会的网站和社交媒体渠道招募患者。该调查通过一个安全的研究数据采集数据库在线进行。根据生物性别对回答进行分析。连续变量以中位数（第25百分位数 - 第75百分位数）表示，分类变量以参与者的数量和比例表示。
共有8919名患者报告医生诊断为POTS并纳入本分析。大多数受访者为女性（93.7%）。女性和男性患者误诊率相似（76.2%对74.9%，P = 0.5），且诊断前看医生的数量相似（5[3 - 8]对5[3 - 8]，P = 0.9）。尽管有这些相似之处，但女性患者的诊断延迟比男性患者更长（1.50[0.25 - 5.25]年对0.92[0.08 - 2.91]年，P < 0.001）。
尽管POTS患者主要为女性，但女性患者在诊断方面比男性患者面临更多挑战。提高对POTS的认识和识别可能有助于减少女性和男性患者的诊断挑战，并改善对患有这种使人衰弱疾病的个体的治疗和管理。
