A Community-Based Trial of Commercially Available Compression Tights in Patients With Postural Orthostatic Tachycardia Syndrome

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS JACC. Clinical electrophysiology Pub Date : 2025-01-01 DOI:10.1016/j.jacep.2024.09.033

Kate M. Bourne BSc , Kavithra Karalasingham BHSc , Tanya Siddiqui MBBS, MPhil , Aishani Patel BSc , Derek Exner MD, MPH , Robert Sheldon MD, PhD , Satish R. Raj MD, MSCI

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Abstract

Background

Compression garments reduce heart rate and symptoms in patients with postural orthostatic tachycardia syndrome in an acute laboratory setting. Patients taking medications controlling heart rate have less benefit from compression than those not on medications. The effectiveness of commercially available garments in a community-based setting, with and without medication use, is not known.

Objectives

The authors sought to evaluate commercially available compression tights in a community-based setting both with, and without, medications modulating heart rate, using a clinical trial with 2 before–after protocols conducted in a randomized crossover fashion.

Methods

Participants (N = 26) held medications during protocol #1 and took medications as normal during protocol #2. For each, participants completed 4, 10-minute active stand tests in the morning (AM) and afternoon (PM) with the garments on (ON) and off (OFF) (AM-OFF, AM-ON, PM-ON, and PM-OFF). Heart rate (Holter monitor) and symptoms (Vanderbilt Orthostatic Symptom Score [VOSS]) were measured for each standing test.

Results

Protocol #1: Standing heart rate was reduced (105 [99-116] beats/min vs 119 [105-130] beats/min; P < 0.001) and symptoms improved (P < 0.001), during AM-ON vs AM-OFF. Standing heart rate (P = 0.04) and symptoms (P = 0.004) increased when compression was removed after several hours. Protocol #2: Standing heart rate was reduced (84 [77-90] beats/min vs 89 [84-100] beats/min; P < 0.001), and symptoms improved (P = 0.03), during AM-ON vs AM-OFF. Standing heart rate (P = 0.02) and symptoms (P < 0.001) increased when compression was removed after several hours.

Conclusions

Commercially available compression tights reduced heart rate and symptoms both acutely and after several hours of use. This additional benefit persisted whether concomitant medications were used. (Compression Garments in the Community With POTS [COM-COM-POTS]; NCT04881318)

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市售紧身衣用于体位性心动过速综合征患者的社区试验。

背景：在一个急性实验室环境下，压缩服可以降低体位性心动过速综合征患者的心率和症状。服用药物控制心率的患者比不服用药物的患者从压迫中获益更少。在社区环境中，无论是否使用药物，市售服装的有效性尚不清楚。目的：作者试图评估市售紧身衣在社区环境中是否有药物调节心率，采用随机交叉方式进行的2个前后方案的临床试验。方法：参与者（N = 26）在方案1期间服用药物，在方案2期间正常服药。每个参与者在上午（AM）和下午（PM）穿着衣服（on）和off （AM- off, AM- on， PM- on和PM- off）完成了4,10分钟的主动站立测试。每次站立试验均测量心率（动态心电图仪）和症状（Vanderbilt Orthostatic Symptom Score [VOSS]）。结果：方案1：站立心率降低（105[99-116]次/分vs 119[105-130]次/分）；P < 0.001)，在AM-ON和AM-OFF期间，症状得到改善（P < 0.001）。数小时后解除压迫时，站立心率（P = 0.04）和症状（P = 0.004）增加。方案2：站立心率降低（84[77-90]次/分vs 89[84-100]次/分）；P < 0.001)，并且在AM-ON和AM-OFF期间症状得到改善（P = 0.03）。数小时后解除压迫时，站立心率（P = 0.02）和症状（P < 0.001）增加。结论：市售紧身衣可在使用数小时后降低心率和症状。无论是否同时使用药物，这种额外的益处都会持续存在。(社区用锅的压缩服装[COM-COM-POTS]；NCT04881318)。

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.