Avtor/Urednik		Kavčič, Niko; Beharić, Amer
Naslov		Vpliv anksiolitika na kvaliteto življenja in na kardiovaskularno avtonomno funkcijo pri bolniku s posturalno ortostatsko tahikardijo
Prevedeni naslov		The influence of anxiolytic therapy on quality of life and cardiovascular autonomic function in patients with postural ortostatic tachycardia
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 44, št. 1
Leto izdaje		2005
Obseg		str. 23-32
Jezik		slo
Abstrakt		Postural orthostatic tachycardia syndrome (POTS) is a disorder of the autonomic nervous system. The pathology is characterised by adrenergic and cardiovagal nerve fibre dysfunction, combined with central abnormality of autonomic regulation. When assuming the upright posture or performing the tilt table testing, patients develop excessive tachycardia and symptoms such as dizziness, syncope, palpitations, anxiety. These are often present even in the absence of any decrease in arterial pressure. Patients with POTS experience limitations in multiple domains of quality of life. A variety of approaches have been used to alleviate symptoms of POTS, including anxiolytic therapy. The aim of the present work was to investigate the efficacy of anxiolytic therapy in patients with POTS. The patients were selected from the neurocardiologic laboratory archives on the basis of orthostatic tachycardia and orthostatic intolerance development upon tilt testing. They completed a set of questionnaires that included measures of quality of life (SF-36) and autonomic symptom severity (ASP). In order to evaluate autonomic nervous system function, blood pressure and ECG during rest, deep breathing, Valsalva maneuver, cold face test and tilt table testing were monitored. After alprazolam therapy for a period of four to five weeks, eleven patients were surveyed and retested. The results show that anxiolytic therapy in patients with POTS does not improve quality of life, nor does it decrease symptoms of orthostatic intolerance or normalise autonomic abnormalities. The results also indicate that anxiety does not play a major role in the pathophysiology of this disease.
Izvleček		Sindrom posturalne ortostatske tahikardije je motnja v delovanju avtonomnega živčnega sistema. Najverjetnejša patofiziološka osnova je prizadetost adrenergičnih in kardiovagalnih živčnih vlaken ter določene motnje centralnega živčnega sistema. Pri vstajanju ali testu z nagibno mizo pri teh bolnikih prekomerno poraste srčni ritem, vendar običajno ne pride do padca krvnega tlaka. Od simptomov se pojavijo omotica, palpitacije, sinkopa, anksioznost. Bolniki imajo slabšo kakovost življenja z omejitvami na večih področjih življenja. Zdravljenje posturalne ortostatske tahikardije je nedorečeno. Pogosto predpisano zdravilo je anksiolitik. Namen najine naloge je bil ugotoviti smotrnost uporabe anksiolitika pri bolnikih s posturalno ortostatsko tahikardijo. Iz arhiva nevrokardiološkega laboratorija sva izbrala bolnike, ki so pri testu z nagibno mizo imeli prekomeren porast srčnega utripa in ob tem simptome ortostatske intolerance. Bolniki so izpolnili vprašalnik SF-36, ki ocenjuje kakovost življenja in vprašalnik ASP, ki ocenjuje težavnost in pogostnost avtonomnih simptomov. Nato smo merili krvni tlak in srčni ritem med mirovanjem, globokim dihanjem, Valsalvinim manevrom, omočitvijo obraza in testom z nagibno mizo ter izračunali parametre za oceno delovanja avtonomnega živčevja. Po štirih do petih tednih jemanja alprazolama smo na enajstih bolnikih ponovili celotno testiranje, vključno z izpolnjevanjem vprašalnika. Rezultati kažejo, da jemanje anksiolitika pri bolnikih s posturalno ortostatsko tahikardijo ne izboljša kakovosti življenja, ne omili simptomov ortostatske intolerance in ne zmanjša motnje v delovanju avtonomnega živčevja. Izhajajoč iz rezultatov najine raziskave zaključujeva, da anksioznost sama po sebi ne predstavlja pomembnejšega dejavnika v etiopatogenezi posturalne ortostatske tahikardije.
Deskriptorji		TACHYCARDIA POSTURE ANTI-ANXIETY AGENTS TILT-TABLE TEST ELECTROCARDIOGRAPHY HEART RATE VALSALVA'S MANEUVER QUESTIONNAIRES