Orthostatic intolerance in survivors of childhood cancer

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• 作者：Annelinde Terlou ; Kathy Ruble ; Anne F. Stapert ; Ho-Choong Chang ; Peter C. Rowe ; Cindy L. Schwartz
• 关键词：Orthostatic intolerance ; Cancer survivors ; Fatigue ; Neurally mediated hypotension (NMH) ; Postural orthostatic tachycardia syndrome (POTS)
• 刊名：European Journal of Cancer
• 出版年：2007
• 出版时间：December 2007
• 年：2007
• 卷：43
• 期：18
• 页码：2685-2690
• 全文大小：161 K

文摘

To compare the prevalence and severity of orthostatic intolerance in survivors of childhood cancer and in healthy controls, and to correlate results of self-reported measures of health status with orthostatic testing in survivors of childhood cancer.

Patient and methods

Thirty-nine survivors of childhood cancer and 56 controls were recruited for this study. Each cancer survivor completed standardised self-report measures and all participants underwent a standing test (5 min supine, 10 min of motionless standing leaning against a wall, followed by another 2 min supine). The main outcomes of the standing test were orthostatic tachycardia (OT), defined as a heart rate increase of at least 30 beats per minute (bpm) during standing, and neurally mediated hypotension (NMH), defined as a drop in systolic blood pressure of at least 25 mm Hg.

Results

OT developed in 22/39 (56 % ) cancer survivors versus 17/56 (30 % ) controls (P = .01). Cancer survivors had a higher baseline and maximum standing heart rate (both P < .001) and a more rapid onset of significant OT (P = .005). No significant difference in scores on self-report measures was found between cancer survivors with or without OT.

Conclusion

This study provides preliminary evidence of a higher rate of orthostatic intolerance in childhood cancer survivors. Further study is warranted to better define whether this is a modifiable risk factor for fatigue in this population, and how orthostatic intolerance interacts with other known risk factors for lowered quality of life.