{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:52:58Z","timestamp":1755795178247,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"1","funder":[{"name":"The Albert Phlsson Research Foundation"},{"name":"Skne University Hospital"},{"name":"The Medical Faculty of Lund University"},{"name":"The Ernhold Lundstrms Research Foundation"},{"name":"The Crafoord Foundation"},{"name":"The Swedish Heart and Lung Foundation"},{"DOI":"10.13039\/501100006310","name":"Swedish Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006310","id-type":"DOI","asserted-by":"crossref"}]},{"name":"European Research Council"},{"name":"The King Gustaf V and Queen Victoria Foundation"},{"name":"The Wallenberg Foundation"},{"name":"ALF-funds"},{"name":"The Region Skne"},{"name":"The Hulda and Conrad Mossfelt Foundation"},{"name":"The Lennart Hanssons Memorial Foundation"},{"name":"The Anna Lisa and Sven-Erik Lundgrens Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2017,3,29]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore the clinical and neuroendocrine characteristics of syndromes of orthostatic intolerance and syncope in young adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two hundred and thirty-six patients aged 18\u201340 years with orthostatic intolerance and\/or syncope were examined by head-up tilt test (HUT). Plasma levels of epinephrine, norepinephrine, renin, C-terminal-pro-arginine-vasopressin (CT-proAVP), C-terminal-endothelin-1 and mid-regional-fragment of pro-atrial-natriuretic-peptide (MR-proANP) were analysed. Patients\u2019 history, haemodynamic parameters and plasma biomarkers were related to main diagnoses such as vasovagal syncope (VVS), postural tachycardia syndrome (POTS), orthostatic hypotension (OH) and negative HUT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>No self-reported symptom of orthostatic intolerance was highly specific for any diagnosis. Patients with VVS (n=103) were more likely to be men (p=0.011) and had lower resting heart rate (HR; 66\u00b111) compared with POTS (73\u00b111; n=72; p=0.001) and negative HUT (74\u00b111; n=39; p=0.001). Patients with POTS demonstrated greater rise in norepinephrine (p=0.008) and CT-proAVP (p=0.033) on standing compared with negative HUT, and lower resting MR-proANP compared with VVS (p=0.04) and OH (p=0.03). Patients with OH had lower resting renin (p=0.03). Subjects with a resting HR &lt;70\u2009and MR-proANP &gt;45\u2009pm\/L had an OR of 3.99 (95 % CI 1.68 to 9.52; p=0.002) for VVS compared with subjects without any of these criteria; if male sex was added the OR was 21.8 (95% CI 3.99 to 119; p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Syndromes of orthostatic intolerance and syncope share many characteristics in younger persons. However, patients with VVS are more likely to be men, have lower HR and higher MR-proANP at rest compared with POTS, which might be taken into account at an early stage of evaluation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2016-000585","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T20:10:19Z","timestamp":1494965419000},"page":"e000585","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Syndromes of orthostatic intolerance and syncope in young adults"],"prefix":"10.1136","volume":"4","author":[{"given":"Viktor","family":"Hamrefors","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Medical Imaging and Physiology, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"},{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmina Medic","family":"Spahic","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Senneby","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Medical Imaging and Physiology, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Sutton","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College, Hammersmith Hospital Campus, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olle","family":"Melander","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artur","family":"Fedorowski","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Cardiology, Sk\u00e5ne University Hospital, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,5,16]]},"reference":[{"key":"2025081710124002000_4.1.e000585.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2006.00595.x"},{"key":"2025081710124002000_4.1.e000585.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-008-0465-0"},{"key":"2025081710124002000_4.1.e000585.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp298"},{"key":"2025081710124002000_4.1.e000585.4","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12021"},{"key":"2025081710124002000_4.1.e000585.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1084"},{"key":"2025081710124002000_4.1.e000585.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.029"},{"key":"2025081710124002000_4.1.e000585.7","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.184937"},{"key":"2025081710124002000_4.1.e000585.8","doi-asserted-by":"crossref","unstructured":"Fedorowski A , Li H , Yu X , et al . 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