In a new study out of the University of California San Diego School of Medicine, researchers found that a drug used for heart failure improves symptoms associated with postural orthostatic tachycardia syndrome, also known as POTS. This complex, debilitating disorder affects the body’s autonomic nervous system, causing a high heart rate, usually when standing up.
Writing in the online journal February 15, 2021 den Journal of the American College of Geology, study authors examined the drug ivabradine and its effect on heart rate, quality of life, and plasma levels of norepinephrine in people living with POTS. Norepinephrine is a weight loss hormone and neurotransmitter. In blood plasma, it is used as a measure of the sympathetic activity of the nervous system. Test participants experienced a decrease in heart rate, improvement in their symptoms and overall quality of life one month after taking the drug.
Ivabradine is a novel FDA-approved agent for heart failure, but based on its approach we thought it could be helpful for patients with POTS as it reduces heart rate without affecting it. blood pressure. When we can lower heart rate, we enable these patients to stand up, something they could not do without previous difficulty because of the POTS diagnosis. “
Pam Taub, MD, Cardiologist, Cardiovascular Institute, UC San Diego Health and Associate Professor of Medicine, UC San Diego School of Medicine
The study included 22 people with an average age of 32 years. All participants were screened and recruited from cardiology clinics at UC San Diego Health from 2018 to 2020.
The study used a randomized, double-blind, placebo-controlled crossover design in which patients started either ivabradine or placebo for one month. At the end of the month, all participants went through a laundry period where no drug or placebo was taken for a week. After the washing period, participants who had previously taken ivabradine switched to placebo and vice versa for one month.
Over the two months, patients also met with researchers for seven different clinical visits in which norepinephrine plasma levels were measured and a head tilt test was performed to monitor the patient’s heart rate while sitting, lying down. or standing.
“Prior to the study, these patients would live with elevated heart rates ranging from 100 to 115 beats per minute when standing,” Taub said. “After taking ivabradine twice daily for one month, the stable heart rate dropped significantly to about 77 beats per minute compared with the placebo group. Participants also reported an improvement in measures. quality of life while on the drug. “
The researchers also noted that ivabradine was well tolerated with no side effects while other drugs used may lower heart rate, such as beta blockers, fatigue and lower blood pressure.
Taub said the study is the first randomized clinical trial using ivabradine to treat POTS.
POTS are usually caused by viral disease, trauma, surgery or emergency bed cover, and usually affect young women who are either athletes or are very active. Currently, treatment is not approved by the FDA for POTS and the condition can have a significant impact on quality of life. Other symptoms of POTS include “brain fog,” lightheadedness, palpitations, tremors, weakness, blurry vision and fatigue.
POTS has recently been identified as a potential “ship-hauler” brand of COVID-19.
“In our contemporary practice, we see patients who were previously infected with COVID-19 present with POTS-compatible symptoms,” said Jonathan Hsu, MD, a cardiologist at UC San Diego Health. “With their similarities, this study leads to the question of whether treatment with ivabradine could help patients with similar symptoms after COVID-19 infection, and may also be an important area for future study. “
The authors stated that they hope that ivabradine will be considered a possible treatment option for those who have been diagnosed with POTS. At present, the drug is not FDA approved for the disease and when used clinically would be an “off-label” use.
“Like patients with COVID-19, patients with POTS need to be followed carefully,” Taub said. “Treatment for POTS needs to be personalized for each person and with this drug, along with lifestyle treatment, including specific exercises for POTS, we hope to see more people recover. on this unfortunate situation. “
Source:
University of California – San Diego