Blood volume deficit in postural orthostatic tachycardia syndrome assessed by semiautomated carbon monoxide rebreathing.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Clinical Autonomic Research Pub Date : 2024-11-30 DOI:10.1007/s10286-024-01091-8

Surat Kulapatana, Vasile Urechie, Stefano Rigo, Abigail Mohr, Yuliya A Vance, Luis E Okamoto, Alfredo Gamboa, Cyndya Shibao, Italo Biaggioni, Raffaello Furlan, André Diedrich

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Abstract

Purpose: The semiautomated carbon monoxide (CO) rebreathing method has been introduced as a noninvasive and radiation-free blood volume estimation method. We tested whether the semiautomated CO rebreathing method can detect the blood volume deficit in postural orthostatic tachycardia syndrome (POTS). In addition, we explored the relationship between blood volume estimated from CO rebreathing and body impedance.

Patients and methods: We recruited 53 subjects (21 female patients with POTS, 19 healthy female participants, and 13 healthy male participants) to record blood volumes and hemodynamic data. Blood volumes were measured by CO rebreathing and segmental body impedance. Linear regression models to predict normal values of red blood cell volume (RBCV), plasma volume (PV), and total blood volume (BV) were developed. Percentage deviations from the predicted normal volumes were calculated.

Results: Patients with POTS had lower RBCV (25.18 ± 3.95 versus 28.57 ± 3.68 mL/kg, p = 0.008, patients with POTS versus healthy female participants), BV (64.53 ± 10.02 versus 76.78 ± 10.00 mL/kg, p < 0.001), and BV deviation (-13.92 ± 10.38% versus -0.02 ± 10.18%, p < 0.001). Patients with POTS had higher supine heart rate (HR) (84 ± 14 versus 69 ± 11 bpm, p < 0.001) and upright HR (123 ± 23 versus 89 ± 22 bpm, p < 0.001). We found a correlation between BV deviation and upright HR in patients with POTS (r = -0.608, p = 0.003), but not in healthy participants. Volumes from the CO rebreathing and body impedance were well correlated (r = 0.629, p < 0.001).

Conclusions: The CO rebreathing method can detect BV deficit, as well as the RBCV deficit in patients with POTS. The negative correlation between BV deviation and upright HR indicates that hypovolemia is one of the pathophysiological causes of POTS. Correlations between body impedance and CO rebreathing volume suggest its usefulness for measurements of volume changes.

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用半自动一氧化碳再呼吸评估体位性心动过速综合征的血容量不足。

目的：介绍一种无创、无辐射的半自动一氧化碳（CO）再呼吸法。我们测试了半自动CO再呼吸法是否可以检测体位性心动过速综合征（POTS）的血容量不足。此外，我们还探讨了CO再呼吸估计的血容量与身体阻抗之间的关系。患者和方法：我们招募了53名受试者（21名女性POTS患者，19名健康女性受试者，13名健康男性受试者）记录血容量和血流动力学数据。用CO再呼吸法和节段性体阻抗法测定血容量。建立了预测红细胞体积（RBCV）、血浆体积（PV）和总血容量（BV）正常值的线性回归模型。计算与预测正常体积的百分比偏差。结果：高压锅患者的RBCV（25.18±3.95 mL/kg比28.57±3.68 mL/kg, p = 0.008）和BV（64.53±10.02 mL/kg比76.78±10.00 mL/kg, p）较低，结论：CO再呼吸法可检测高压锅患者的BV缺陷和RBCV缺陷。BV偏差与直立HR呈负相关，提示低血容量是POTS的病理生理原因之一。身体阻抗与CO再呼吸量之间的相关性表明其对测量容积变化的有用性。

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来源期刊

Clinical Autonomic Research 医学-临床神经学

CiteScore

7.40

自引率

6.90%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.