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Splanchnic Venous Compression Enhances the Effects of ß‐Blockade in the Treatment of Postural Tachycardia Syndrome, 2020, Smith et al

Discussion in ''Conditions related to ME/CFS' news and research' started by ahimsa, Jul 17, 2020.

  1. ahimsa

    ahimsa Senior Member (Voting Rights)

    Messages:
    1,751
    Location:
    Oregon, USA
    I happened to stumble across this POTS research today:

    Splanchnic Venous Compression Enhances the Effects of ß‐Blockade in the Treatment of Postural Tachycardia Syndrome

    Emily C. Smith, André Diedrich, Satish R. Raj, Alfredo Gamboa, Cyndya A. Shibao, Bonnie K. Black, Amanda Peltier, Sachin Y. Paranjape, Italo Biaggioni, and Luis E. Okamoto

    Journal of the American Heart Association

    https://www.ahajournals.org/doi/full/10.1161/JAHA.120.016196

    I don't know how practical this is but thought I'd share it.
     
  2. Trish

    Trish Moderator Staff Member

    Messages:
    41,548
    Location:
    UK
    Abstract
    Background
    Splanchnic venous pooling induced by upright posture triggers a compensatory increase in heart rate (HR), a response that is exaggerated in patients with postural tachycardia syndrome. To assess whether abdominal compression attenuates orthostatic tachycardia and improves symptoms, 18 postural tachycardia syndrome patients (32±2 years) were randomized to receive either abdominal compression (40 mm Hg applied with an inflatable binder ≈2 minutes before standing) or propranolol (20 mg) in a placebo‐controlled, crossover study.

    Methods and Results
    Systolic blood pressure, HR, and symptoms were assessed while seated and standing, before and 2 hours postdrug. As expected, propranolol decreased standing HR compared with placebo (81±2 versus 98±4 beats per minute; P<0.001) and was associated with lower standing systolic blood pressure (93±2 versus 100±2 mm Hg for placebo; P=0.002). Compression had no effect on standing HR (96±4 beats per minute) but increased standing systolic blood pressure compared with placebo and propranolol (106±2 mm Hg; P<0.01). Neither propranolol nor compression improved symptoms compared with placebo. In 16 patients we compared the combination of abdominal compression and propranolol with propranolol alone. The combination had no additional effect on standing HR (81±2 beats per minute for both interventions) but prevented the decrease in standing systolic blood pressure produced by propranolol (98±2 versus 93±2 mm Hg for propranolol; P=0.029), and significantly improved total symptom burden (−6±2 versus −1±2 for propranolol; P=0.041).

    Conclusions
    Splanchnic venous compression alone did not improve HR or symptoms but prevented the blood pressure decrease produced by propranolol. The combination was more effective in improving symptoms than either alone. Splanchnic venous compression can be a useful adjuvant therapy to propranolol in postural tachycardia syndrome.
     
    alktipping, ahimsa and MEMarge like this.
  3. alktipping

    alktipping Senior Member (Voting Rights)

    Messages:
    1,102
    sounds like it would be very uncomfortable to wear especially for people with chronic pain .
     
    ahimsa and Trish like this.

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