UT researchers contribute to largest study to date on new treatment of syncope

July 13, 2011 | Research, UToday
By Feliza Casano

Building on The University of Toledo’s reputation as one of the world’s leading centers for the diagnosis and treatment of postural orthostatic tachycardia syndrome, a team of seven UT researchers recently co-authored the largest study ever published on treatment of the syndrome.

The study, “Pyridostigmine in the Treatment of Postural Orthostatic Tachycardia: A Single-Center Experience,” was published in the June issue of Pacing and Clinical Electrophysiology.

A team of medical researchers at UT collaborated on the study, which was conducted while treating patients at the Syncope and Autonomic Disorders Center on Health Science Campus. The authors include Dr. Khalil Kanjwal, Dr. Beverly Karabin, Dr. Mujeeh Sheikh, Dr. Yousuf Kanjwal, Dr. Bilal Saeed and Dr. Blair Grubb in the Division of Cardiology in the Department of Medicine, as well as Dr. Lawrence Elmer of the Department of Neurology.

Postural orthostatic tachycardia syndrome, abbreviated POTS, is a disorder that affects the body’s ability to maintain blood pressure when in an upright position. Researchers estimate more than 500,000 people in the United States are affected by the syndrome.

The study, which included more than 200 patient participants who did not respond readily to other POTS treatments, examined the long-term use of the drug pyridostigmine to manage the disorder. Grubb said pyridostigmine primarily has been used to treat another disease called myasthenia gravis and only recently began to be used for POTS.

The study concluded that patients who could tolerate the drug showed positive benefits with regard to blood pressure and other POTS symptoms.

Pyridostigmine also is being used to treat blood pressure disturbances in patients with Parkinson’s disease, which is the area Elmer specializes in. Over time, patients with the disease sometimes develop autonomic problems, including fainting and low blood pressure.

“Twenty or 30 years ago, we did not recognize these autonomic abnormalities in Parkinson’s disease, possibly because people with Parkinson’s disease were not living long enough for some issues to develop,” Elmer said. “Now people with Parkinson’s often live normal lifespans, so these changes become bigger problems. There is a high likelihood, possibly more than 50 percent, that Parkinson’s patients will eventually have autonomic problems.”

More than one million people in the United States have Parkinson’s disease, Elmer said, so it is likely that hundreds of thousands of these patients may develop autonomic problems, including orthostatic hypotension, related to the disease.

According to Grubb, 75 percent of UT Medical Center’s POTS patients are from out of state, and 10 percent of POTS patients arrive from outside the country to seek care here. The medical center treats more than 4,000 patients each year for POTS and more who experience similar symptoms derived from other autonomic disorders.

Elmer said the most important thing about the study is that it helps doctors at UT improve not only the health, but also the quality of life for patients.

“If we can help people so their health and quality of life are better, it is very gratifying,” he said. “That’s one of the greatest rewards of being involved in health care at UTMC.”

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