Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion

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Standard

Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. / Breier, Nicholas C.; Paranjape, Sachin Y.; Scudder, Shea; Mehr, Shahram E.; Diedrich, Andre'; Flynn, Charles R.; Okamoto, Luis E.; Hartmann, Bolette; Gasbjerg, Lærke Smidt; Shibao, Cyndya A.

I: Hypertension, Bind 79, Nr. 5, 2022, s. e89-e99.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Breier, NC, Paranjape, SY, Scudder, S, Mehr, SE, Diedrich, A, Flynn, CR, Okamoto, LE, Hartmann, B, Gasbjerg, LS & Shibao, CA 2022, 'Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion', Hypertension, bind 79, nr. 5, s. e89-e99. https://doi.org/10.1161/HYPERTENSIONAHA.121.17852

APA

Breier, N. C., Paranjape, S. Y., Scudder, S., Mehr, S. E., Diedrich, A., Flynn, C. R., Okamoto, L. E., Hartmann, B., Gasbjerg, L. S., & Shibao, C. A. (2022). Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. Hypertension, 79(5), e89-e99. https://doi.org/10.1161/HYPERTENSIONAHA.121.17852

Vancouver

Breier NC, Paranjape SY, Scudder S, Mehr SE, Diedrich A, Flynn CR o.a. Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. Hypertension. 2022;79(5):e89-e99. https://doi.org/10.1161/HYPERTENSIONAHA.121.17852

Author

Breier, Nicholas C. ; Paranjape, Sachin Y. ; Scudder, Shea ; Mehr, Shahram E. ; Diedrich, Andre' ; Flynn, Charles R. ; Okamoto, Luis E. ; Hartmann, Bolette ; Gasbjerg, Lærke Smidt ; Shibao, Cyndya A. / Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. I: Hypertension. 2022 ; Bind 79, Nr. 5. s. e89-e99.

Bibtex

@article{4002f003377e4a1da4c92aa8c6feb200,
title = "Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion",
abstract = "BACKGROUND: Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS. METHODS: Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing. RESULTS: Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm, P=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL, P=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%, P=0.033 with a concomitant decline in upright stroke volume, -10.3±11.90% versus 3.3±13.7%, P=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (P=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (P=0.001), GIP (glucose-dependent insulinotropic polypeptide; P=0.001), peptide YY (P=0.016), and pancreatic polypeptide (P=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall. CONCLUSIONS: The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.",
keywords = "blood pressure, carbohydrates, glucose, heart rate, incretins, tachycardia",
author = "Breier, {Nicholas C.} and Paranjape, {Sachin Y.} and Shea Scudder and Mehr, {Shahram E.} and Andre' Diedrich and Flynn, {Charles R.} and Okamoto, {Luis E.} and Bolette Hartmann and Gasbjerg, {L{\ae}rke Smidt} and Shibao, {Cyndya A.}",
year = "2022",
doi = "10.1161/HYPERTENSIONAHA.121.17852",
language = "English",
volume = "79",
pages = "e89--e99",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams & Wilkins",
number = "5",

}

RIS

TY - JOUR

T1 - Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion

AU - Breier, Nicholas C.

AU - Paranjape, Sachin Y.

AU - Scudder, Shea

AU - Mehr, Shahram E.

AU - Diedrich, Andre'

AU - Flynn, Charles R.

AU - Okamoto, Luis E.

AU - Hartmann, Bolette

AU - Gasbjerg, Lærke Smidt

AU - Shibao, Cyndya A.

PY - 2022

Y1 - 2022

N2 - BACKGROUND: Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS. METHODS: Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing. RESULTS: Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm, P=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL, P=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%, P=0.033 with a concomitant decline in upright stroke volume, -10.3±11.90% versus 3.3±13.7%, P=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (P=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (P=0.001), GIP (glucose-dependent insulinotropic polypeptide; P=0.001), peptide YY (P=0.016), and pancreatic polypeptide (P=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall. CONCLUSIONS: The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.

AB - BACKGROUND: Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS. METHODS: Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing. RESULTS: Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm, P=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL, P=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%, P=0.033 with a concomitant decline in upright stroke volume, -10.3±11.90% versus 3.3±13.7%, P=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (P=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (P=0.001), GIP (glucose-dependent insulinotropic polypeptide; P=0.001), peptide YY (P=0.016), and pancreatic polypeptide (P=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall. CONCLUSIONS: The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.

KW - blood pressure

KW - carbohydrates

KW - glucose

KW - heart rate

KW - incretins

KW - tachycardia

U2 - 10.1161/HYPERTENSIONAHA.121.17852

DO - 10.1161/HYPERTENSIONAHA.121.17852

M3 - Journal article

C2 - 35232225

AN - SCOPUS:85126851400

VL - 79

SP - e89-e99

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 5

ER -

ID: 305185041