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. 2023 Aug;33(4):469-477.
doi: 10.1007/s10286-023-00955-9. Epub 2023 Jun 20.

Poor health-related quality of life in postural orthostatic tachycardia syndrome in comparison with a sex- and age-matched normative population

Marie-Claire Seeley  1   2 , Celine Gallagher  1   2 , Eric Ong  3 , Amy Langdon  3 , Jonathan Chieng  1 , Danielle Bailey  1 , Annabelle Dennis  1 , Nikki McCaffrey  4 , Dennis H Lau  5   6   7
Affiliations

Poor health-related quality of life in postural orthostatic tachycardia syndrome in comparison with a sex- and age-matched normative population

Marie-Claire Seeley et al. Clin Auton Res. 2023 Aug.

Abstract

Purpose: The effect of postural orthostatic tachycardia syndrome (POTS) on health-related quality of life (HrQoL) remains poorly studied. Here, we sought to compare the HrQoL in individuals with POTS to a normative age-/sex-matched population.

Methods: Participants enrolled in the Australian POTS registry between 5 August 2021 and 30 June 2022 were compared with propensity-matched local normative population data from the South Australian Health Omnibus Survey. The EQ-5D-5L instrument was used to assess HrQoL across the five domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) with global health rating assessed with a visual analog scale (EQ-VAS). A population-based scoring algorithm was applied to the EQ-5D-5L data to calculate utility scores. Hierarchical multiple regression analyses were undertaken to explore predictors of low utility scores.

Results: A total of 404 participants (n = 202 POTS; n = 202 normative population; median age 28 years, 90.6% females) were included. Compared with the normative population, the POTS cohort demonstrated significantly higher burden of impairment across all EQ-5D-5L domains (all P < 0.001), lower median EQ-VAS (p < 0.001), and lower utility scores (p < .001). The lower EQ-VAS and utility scores in the POTS cohort were universal in all age groups. Severity of orthostatic intolerance symptoms, female sex, fatigue scores, and comorbid diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome were independent predictors of reduced HrQoL in POTS. The disutility in those with POTS was lower than many chronic health conditions.

Conclusions: This is the first study to demonstrate significant impairment across all subdomains of EQ-5D-5L HrQoL in the POTS cohort as compared with a normative population.

Trial registration: ACTRN12621001034820.

Keywords: Global health rating; Health utility; Health-related quality of life; Orthostatic intolerance; Postural orthostatic tachycardia syndrome.

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Figures

Fig. 1
Fig. 1
Comparative mean EQ-5D-5L score by subdomain
Fig. 2
Fig. 2
Comparative mean EQ-VAS and utility scores by age category
Fig. 3
Fig. 3
Mean EQ-5D-5L scores in comparison with other disease states as reported by Zhou et al. Mean score with 95% confidence interval. MS; multiple sclerosis, POTS; postural orthostatic tachycardia syndrome, CKD; chronic kidney disease, COPD, chronic obstructive pulmonary disease, CVD; cardiovascular disease, HIV; human immunodeficiency virus
See this image and copyright information in PMC

References

    1. Raj SR, Guzman JC, Harvey P, Richer L, Schondorf R, Seifer C, et al. Canadian cardiovascular society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Can J Cardiol. 2020;36(3):357–372. doi: 10.1016/j.cjca.2019.12.024. - DOI - PubMed
    1. Sheldon RS, Grubb BP, 2nd, Olshansky B, Shen W-K, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41–e63. doi: 10.1016/j.hrthm.2015.03.029. - DOI - PMC - PubMed
    1. Boris JR, Huang J, Bernadzikowski T. Orthostatic heart rate does not predict symptomatic burden in pediatric patients with chronic orthostatic intolerance. Clin Auton Res. 2020;30(1):19–28. doi: 10.1007/s10286-019-00622-y. - DOI - PubMed
    1. Wells R, Elliott AD, Mahajan R, Page A, Iodice V, Sanders P, et al. Efficacy of therapies for postural tachycardia syndrome: a systematic review and meta-analysis. Mayo Clin Proc. 2018;93(8):1043–1053. doi: 10.1016/j.mayocp.2018.01.025. - DOI - PubMed
    1. Wells R, Spurrier AJ, Linz D, Gallagher C, Mahajan R, Sanders P, et al. Postural tachycardia syndrome: current perspectives. Vasc health risk manag. 2017;14:1–11. doi: 10.2147/VHRM.S127393. - DOI - PMC - PubMed

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