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Cerebrovascular regulation in the postural orthostatic tachycardia syndrome (POTS)Patients with the postural orthostatic tachycardia syndrome (POTS) have symptoms of orthostatic intolerance despite having a normal orthostatic blood pressure (BP), which suggests some impairment of cerebrovascular regulation. Cerebrovascular autoregulation refers to the maintenance of normal cerebral blood flow in spite of changing BP. Mechanisms of autoregulation include myogenic, metabolic and neurogenic vasoregulation. Beat-to-beat recording of blood-flow velocity (BFV) is possible using transcranial Doppler imaging. It is possible to evaluate autoregulation by regressing deltaBFV to deltaBP during head-up tilt. A number of dynamic methods, relating deltaBFV to deltaBP during sudden induced changes in BP by occluding then releasing peripheral arterial flow or by the Valsalva maneuver. The deltaBFV to deltaBP provides an index of autoregulation. In orthostatic hypotension, the autoregulated range is typically expanded. In contrast, paradoxical vasoconstriction occurs in POTS because of an increased depth of respiration, resulting in hypocapnic cerebrovascular constriction, and impaired autoregulation.
Document ID
20040142054
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Low, P. A.
(Mayo Clinic Rochester, Minnesota 55905, United States)
Novak, V.
Spies, J. M.
Novak, P.
Petty, G. W.
Date Acquired
August 22, 2013
Publication Date
February 1, 1999
Publication Information
Publication: The American journal of the medical sciences
Volume: 317
Issue: 2
ISSN: 0002-9629
Subject Category
Life Sciences (General)
Funding Number(s)
CONTRACT_GRANT: PO1-NS32352
Distribution Limits
Public
Copyright
Other
Keywords
Review
Review, Tutorial
NASA Discipline Cardiopulmonary
Non-NASA Center

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