BACKGROUND Postural orthostatic tachycardia syndrome (POTS) is a frequently diagnosed cardiovascular disorder after COVID-19 infection. POTS is characterized by the presence of excessive sinus tachycardia on standing without a fall in blood pressure (BP). We investigated the BP profile using 24-hour ambulatory BP monitoring in patients with new-onset POTS after COVID-19 compared with prepandemic population-based controls. METHODS We performed a case-control study in 100 patients (mean age, 40.0±12.9 years; 85% women) with verified post-COVID-19 new-onset POTS diagnosed by a positive head-up tilt testing versus 100 controls from a population-based cohort with a negative active standing test, no history of syncope, POTS, or endocrine disease (mean age, 42.3±14.0 years; 78% women). Twenty-four-hour BP profile was assessed for circadian BP variation including hypotensive systolic BP (SBP) episodes (<80, <90, and <100 mm Hg). RESULTS Patients with post-COVID-19 POTS had significantly higher nighttime SBP, but not daytime SBP, and more daytime SBP hypotensive episodes compared with controls. Nondipping (34% versus 19%; P<0.001) and reverse dipping patterns (9% versus 0%; P<0.001) were more frequent in post-COVID-19 POTS. In the logistic regression, patients with post-COVID-19 POTS had significantly higher mean 24-hour SBP (odds ratio, 1.08 [95% CI, 1.04-1.11]; P<0.001) and nighttime SBP (odds ratio, 1.07 [95% CI, 1.04-1.10]; P<0.001), independent of age and sex. CONCLUSIONS Patients with post-COVID-19 POTS demonstrate higher mean 24-hour and nighttime SBP and show disruptions of circadian BP rhythm regulation compared with population-based controls, as well as more daytime hypotensive episodes. Future studies are needed to test whether patients with post-COVID-19 POTS may benefit from tailored BP therapy.

中文翻译：

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COVID 后 POTS 中的血压调节：超越窦性心动过速。


背景 体位性直立性心动过速综合征 （POTS） 是 COVID-19 感染后经常被诊断出的心血管疾病。POTS 的特征是站立时出现过度的窦性心动过速，而血压 （BP） 没有下降。与大流行前基于人群的对照相比，我们使用 24 小时动态血压监测调查了 COVID-19 后新发 POTS 患者的血压曲线。方法 我们对 100 名患者 （平均年龄 40.0±12.9 岁;85% 为女性） 进行了一项病例对照研究，这些患者经证实的 COVID-19 后新发 POTS 通过正面倾斜试验阳性诊断为 COVID-19 后新发 POTS，而 100 名来自人群队列的对照，活动站立试验阴性，无晕厥、POTS 或内分泌疾病病史 （平均年龄 42.3±14.0 岁;78% 为女性）。评估 24 小时血压曲线的昼夜节律血压变化，包括低血压收缩压 （SBP） 发作 （<80、<90 和 <100 mm Hg）。结果 与对照组相比，COVID-19 后 POTS 患者的夜间 SBP 显着升高，但白天 SBP 不高，白天 SBP 低血压发作更多。非浸渍 （34% 对 19%;P<0.001）和反向浸入模式 （9% 对 0%;P<0.001） 在 COVID-19 后 POTS 中更常见。在 logistic 回归中，COVID-19 后 POTS 患者的平均 24 小时 SBP 显著升高（比值比，1.08 [95% CI，1.04-1.11];P<0.001） 和夜间 SBP （比值比，1.07 [95% CI，1.04-1.10];P<0.001），与年龄和性别无关。结论 与基于人群的对照组相比，COVID-19 后 POTS 患者表现出更高的平均 24 小时和夜间 SBP，并显示昼夜节律调节中断，以及更多的白天低血压发作。 需要进一步的研究来测试 COVID-19 后 POTS 患者是否可以从量身定制的血压治疗中受益。