Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome

Abigail S L Stickford, Tiffany B. Vangundy, Benjamin D Levine, Qi Fu

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Patients with the postural orthostatic tachycardia syndrome (POTS) are primarily premenopausal women, which may be attributed to female sex hormones. We tested the hypothesis that hormonal fluctuations of the menstrual cycle alter sympathetic neural activity and orthostatic tolerance in POTS women. Ten POTS women were studied during the early follicular (EF) and mid-luteal (ML) phases of the menstrual cycle. Haemodynamics and muscle sympathetic nerve activity (MSNA) were measured when supine, during 60 deg upright tilt for 45 min or until presyncope, and during the cold pressor test (CPT) and Valsalva manoeuvres. Blood pressure and total peripheral resistance were higher during rest and tilting in the ML than EF phase; however, heart rate, stroke volume and cardiac output were similar between phases. There were no mean ± SD differences in MSNA burst frequency (8 ± 8 EF phase vs. 10 ± 10 bursts min<sup>-1</sup> ML phase at rest; 34 ± 15 EF phase vs. 36 ± 16 bursts min<sup>-1</sup> ML phase at 5 min tilt), burst incidence or total activity, nor any differences in the cardiovagal and sympathetic baroreflex sensitivities between phases under any condition. The incidence of presyncope was also the same between phases. There were no differences in haemodynamic or sympathetic responses to CPT or Valsalva. These results suggest that the menstrual cycle does not affect sympathetic neural activity but modulates blood pressure and vasoconstriction in POTS women during tilting. Thus, factors other than sympathetic neural activity are probably responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS.

Original languageEnglish (US)
Pages (from-to)2131-2143
Number of pages13
JournalJournal of Physiology
Volume593
Issue number9
DOIs
StatePublished - May 1 2015

Fingerprint

Postural Orthostatic Tachycardia Syndrome
Menstrual Cycle
Follicular Phase
Luteal Phase
Syncope
Orthostatic Intolerance
Hemodynamics
Blood Pressure
Valsalva Maneuver
Muscles
Baroreflex
Corpus Luteum
Incidence
Gonadal Steroid Hormones
Vasoconstriction
Cardiac Output
Vascular Resistance
Stroke Volume
Heart Rate

ASJC Scopus subject areas

  • Physiology

Cite this

Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome. / Stickford, Abigail S L; Vangundy, Tiffany B.; Levine, Benjamin D; Fu, Qi.

In: Journal of Physiology, Vol. 593, No. 9, 01.05.2015, p. 2131-2143.

Research output: Contribution to journalArticle

@article{a0e1014e81a54f309138cf513ee5917d,
title = "Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome",
abstract = "Patients with the postural orthostatic tachycardia syndrome (POTS) are primarily premenopausal women, which may be attributed to female sex hormones. We tested the hypothesis that hormonal fluctuations of the menstrual cycle alter sympathetic neural activity and orthostatic tolerance in POTS women. Ten POTS women were studied during the early follicular (EF) and mid-luteal (ML) phases of the menstrual cycle. Haemodynamics and muscle sympathetic nerve activity (MSNA) were measured when supine, during 60 deg upright tilt for 45 min or until presyncope, and during the cold pressor test (CPT) and Valsalva manoeuvres. Blood pressure and total peripheral resistance were higher during rest and tilting in the ML than EF phase; however, heart rate, stroke volume and cardiac output were similar between phases. There were no mean ± SD differences in MSNA burst frequency (8 ± 8 EF phase vs. 10 ± 10 bursts min-1 ML phase at rest; 34 ± 15 EF phase vs. 36 ± 16 bursts min-1 ML phase at 5 min tilt), burst incidence or total activity, nor any differences in the cardiovagal and sympathetic baroreflex sensitivities between phases under any condition. The incidence of presyncope was also the same between phases. There were no differences in haemodynamic or sympathetic responses to CPT or Valsalva. These results suggest that the menstrual cycle does not affect sympathetic neural activity but modulates blood pressure and vasoconstriction in POTS women during tilting. Thus, factors other than sympathetic neural activity are probably responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS.",
author = "Stickford, {Abigail S L} and Vangundy, {Tiffany B.} and Levine, {Benjamin D} and Qi Fu",
year = "2015",
month = "5",
day = "1",
doi = "10.1113/JP270088",
language = "English (US)",
volume = "593",
pages = "2131--2143",
journal = "Journal of Physiology",
issn = "0022-3751",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome

AU - Stickford, Abigail S L

AU - Vangundy, Tiffany B.

AU - Levine, Benjamin D

AU - Fu, Qi

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Patients with the postural orthostatic tachycardia syndrome (POTS) are primarily premenopausal women, which may be attributed to female sex hormones. We tested the hypothesis that hormonal fluctuations of the menstrual cycle alter sympathetic neural activity and orthostatic tolerance in POTS women. Ten POTS women were studied during the early follicular (EF) and mid-luteal (ML) phases of the menstrual cycle. Haemodynamics and muscle sympathetic nerve activity (MSNA) were measured when supine, during 60 deg upright tilt for 45 min or until presyncope, and during the cold pressor test (CPT) and Valsalva manoeuvres. Blood pressure and total peripheral resistance were higher during rest and tilting in the ML than EF phase; however, heart rate, stroke volume and cardiac output were similar between phases. There were no mean ± SD differences in MSNA burst frequency (8 ± 8 EF phase vs. 10 ± 10 bursts min-1 ML phase at rest; 34 ± 15 EF phase vs. 36 ± 16 bursts min-1 ML phase at 5 min tilt), burst incidence or total activity, nor any differences in the cardiovagal and sympathetic baroreflex sensitivities between phases under any condition. The incidence of presyncope was also the same between phases. There were no differences in haemodynamic or sympathetic responses to CPT or Valsalva. These results suggest that the menstrual cycle does not affect sympathetic neural activity but modulates blood pressure and vasoconstriction in POTS women during tilting. Thus, factors other than sympathetic neural activity are probably responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS.

AB - Patients with the postural orthostatic tachycardia syndrome (POTS) are primarily premenopausal women, which may be attributed to female sex hormones. We tested the hypothesis that hormonal fluctuations of the menstrual cycle alter sympathetic neural activity and orthostatic tolerance in POTS women. Ten POTS women were studied during the early follicular (EF) and mid-luteal (ML) phases of the menstrual cycle. Haemodynamics and muscle sympathetic nerve activity (MSNA) were measured when supine, during 60 deg upright tilt for 45 min or until presyncope, and during the cold pressor test (CPT) and Valsalva manoeuvres. Blood pressure and total peripheral resistance were higher during rest and tilting in the ML than EF phase; however, heart rate, stroke volume and cardiac output were similar between phases. There were no mean ± SD differences in MSNA burst frequency (8 ± 8 EF phase vs. 10 ± 10 bursts min-1 ML phase at rest; 34 ± 15 EF phase vs. 36 ± 16 bursts min-1 ML phase at 5 min tilt), burst incidence or total activity, nor any differences in the cardiovagal and sympathetic baroreflex sensitivities between phases under any condition. The incidence of presyncope was also the same between phases. There were no differences in haemodynamic or sympathetic responses to CPT or Valsalva. These results suggest that the menstrual cycle does not affect sympathetic neural activity but modulates blood pressure and vasoconstriction in POTS women during tilting. Thus, factors other than sympathetic neural activity are probably responsible for the symptoms of orthostatic intolerance across the menstrual cycle in women with POTS.

UR - http://www.scopus.com/inward/record.url?scp=84928829915&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928829915&partnerID=8YFLogxK

U2 - 10.1113/JP270088

DO - 10.1113/JP270088

M3 - Article

C2 - 25656420

AN - SCOPUS:84928829915

VL - 593

SP - 2131

EP - 2143

JO - Journal of Physiology

JF - Journal of Physiology

SN - 0022-3751

IS - 9

ER -