{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T12:13:46Z","timestamp":1761394426144},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,6,3]],"date-time":"2014-06-03T00:00:00Z","timestamp":1401753600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2014,6]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Postural tachycardia syndrome (POTS<\/jats:styled-content>) manifests as marked tachycardia while standing. We noticed two forms of circulatory response to orthostatic stress in POTS<\/jats:styled-content>. We investigated cardiovascular and autonomic nervous response to orthostatic stress in the two forms.<\/jats:p><\/jats:sec>Methods<\/jats:title>We studied 79 patients with POTS<\/jats:styled-content> and 38 healthy control subjects (Ct<\/jats:styled-content>). Beat\u2010to\u2010beat blood pressure (BP<\/jats:styled-content>) and heart rate (HR<\/jats:styled-content>) were non\u2010invasively and continuously measured in the supine and standing positions. Autonomic nervous function was evaluated on power spectral analysis of HR<\/jats:styled-content> variability and diastolic BP<\/jats:styled-content> variability. We divided the subjects into two groups: standing\u2010induced tachycardia (SI<\/jats:styled-content> group; increase in HR<\/jats:styled-content> \u226535\u2009beats\/min) and supine tachycardia (S<\/jats:styled-content>u group; standing HR<\/jats:styled-content> \u2265115\u2009beats\/min with standing\u2010induced HR<\/jats:styled-content> increase <35\u2009beats\/min).<\/jats:p><\/jats:sec>Results<\/jats:title>The Su<\/jats:styled-content> group had higher supine BP<\/jats:styled-content> and HR<\/jats:styled-content> compared with the other groups, indicating dominant sympathetic control of the heart in the supine position. While rising, the SI<\/jats:styled-content> group had a higher increase in HR<\/jats:styled-content> than the Ct<\/jats:styled-content> group, indicating excessive withdrawal of vagal tone. The Su<\/jats:styled-content> group had a smaller increase in HR<\/jats:styled-content> and a greater decrease of systolic BP<\/jats:styled-content> and cardiac index by standing compared with the SI<\/jats:styled-content> group. These results suggest that compensatory mechanisms of sympathetic function during standing failed in the Su<\/jats:styled-content> group, probably because of exhaustion by the nearly maximum effort to generate sympathetic drive even in the supine position with low central blood volume.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>There is a difference between the two types of POTS<\/jats:styled-content>, in the balance of resting autonomic function and hemodynamic response to standing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.12284","type":"journal-article","created":{"date-parts":[[2014,1,13]],"date-time":"2014-01-13T14:54:31Z","timestamp":1389624871000},"page":"328-335","source":"Crossref","is-referenced-by-count":9,"title":["Variant cardiovascular regulation in children with postural tachycardia syndrome"],"prefix":"10.1111","volume":"56","author":[{"given":"Seiji","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsugu","family":"Kajiura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Kanbara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Yao Tokushukai Hospital Yao Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahoko","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Tamai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Osaka Medical College Takatsuki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,6,3]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Abnormal static circulatory phenomena and their symptoms: Arterial orthostatic anemia as neglected clinical picture","volume":"33","author":"Bjure A","year":"1927","journal-title":"Upsala L\u00e4karef\u00f6ren. 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