RT Journal Article
SR Electronic
T1 Orthodeoxia and postural orthostatic tachycardia in patients with pulmonary arteriovenous malformations: a prospective 8-year series
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 1046
OP 1047
DO 10.1136/thoraxjnl-2014-205289
VO 69
IS 11
A1 V Santhirapala
A1 B Chamali
A1 H McKernan
A1 H C Tighe
A1 L C Williams
A1 J T Springett
A1 H R Bellenberg
A1 A J Whitaker
A1 C L Shovlin
YR 2014
UL http://thorax.bmj.com/content/69/11/1046.abstract
AB Postural changes in 258 patients with pulmonary arteriovenous malformations (PAVMs) reviewed between 2005 and 2013 were evaluated prospectively using validated pulse oximetry methods. Of the 257 completing the test, 75 (29%) demonstrated orthodeoxia with an oxygen saturation fall of at least 2% on standing. None described platypnoea (dyspnoea on standing). The heart rate was consistently higher in the erect posture: 74 (29%) had a postural orthostatic tachycardia of ≥20 min−1, and in 25 (10%) this exceeded 30 min−1. Orthostatic tachycardia was more pronounced in PAVM patients than controls without orthodeoxia (age-adjusted coefficient 5.5 (95% CIs 2.6, 8.4) min−1, p<0.001). For PAVM patients, the age-adjusted pulse rise was 0.79 min−1 greater for every 1% greater drop in oxygen saturation on standing (p<0.001). In contrast to the postural orthostatic tachycardia syndrome, in this population, there was a trend for more pronounced orthostatic tachycardia to be associated with better exercise tolerance.