Evidence map›Paper›PMID 39614968›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2025

Blood volume deficit in postural orthostatic tachycardia syndrome assessed by semiautomated carbon monoxide rebreathing.

Surat Kulapatana, Vasile Urechie, Stefano Rigo, Abigail Mohr, Yuliya A Vance, Luis E Okamoto, Alfredo Gamboa, Cyndya Shibao, Italo Biaggioni, Raffaello Furlan and 1 more

Abstract read
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Hyperadrenergic postural tachycardia syndrome associated with augmented neurovascular transduction.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  2. Natriuretic peptide signaling as a therapeutic target in POTS: physiological opportunities and caveats.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Surat KulapatanaAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Vasile UrechieAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Stefano RigoAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Abigail MohrTulane University School of Medicine, New Orleans, USA.
Yuliya A VanceAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Luis E OkamotoAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Alfredo GamboaAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Cyndya ShibaoAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Italo BiaggioniAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA.
Raffaello FurlanHumanitas Clinical and Research Center- IRCCS, Via Alessandro Manzoni, 56, Rozzano, Italy.
André DiedrichAutonomic Dysfunction Center, Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, 1161 21 Avenue South, Suite S3116 MCN, Nashville, TN, 37232‑2600, USA. andre.diedrich@vumc.org.ORCID http://orcid.org/0000-0001-5643-0294

Funding

Autonomic Determinants of Postural Tachycardia SyndromeR01HL142583 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 2019 to 2022
$1.7M
Autonomic Determinants of Postural Tachycardia SyndromeR56HL142583 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DIEDRICH, ANDRE · 2018 to 2018
$391k
NHLBI NIH HHS R01 HL142583NHLBI NIH HHS R56 HL142583
6 · The paper itself

Abstract

purposeThe semiautomated carbon monoxide (CO) rebreathing method has been introduced as a noninvasive and radiation-free blood volume estimation method. We tested whether the semiautomated CO rebreathing method can detect the blood volume deficit in postural orthostatic tachycardia syndrome (POTS). In addition, we explored the relationship between blood volume estimated from CO rebreathing and body impedance. PATIENTS AND

methodsWe recruited 53 subjects (21 female patients with POTS, 19 healthy female participants, and 13 healthy male participants) to record blood volumes and hemodynamic data. Blood volumes were measured by CO rebreathing and segmental body impedance. Linear regression models to predict normal values of red blood cell volume (RBCV), plasma volume (PV), and total blood volume (BV) were developed. Percentage deviations from the predicted normal volumes were calculated.

resultsPatients with POTS had lower RBCV (25.18 ± 3.95 versus 28.57 ± 3.68 mL/kg, p = 0.008, patients with POTS versus healthy female participants), BV (64.53 ± 10.02 versus 76.78 ± 10.00 mL/kg, p < 0.001), and BV deviation (-13.92 ± 10.38% versus -0.02 ± 10.18%, p < 0.001). Patients with POTS had higher supine heart rate (HR) (84 ± 14 versus 69 ± 11 bpm, p < 0.001) and upright HR (123 ± 23 versus 89 ± 22 bpm, p < 0.001). We found a correlation between BV deviation and upright HR in patients with POTS (r = -0.608, p = 0.003), but not in healthy participants. Volumes from the CO rebreathing and body impedance were well correlated (r = 0.629, p < 0.001).

conclusionsThe CO rebreathing method can detect BV deficit, as well as the RBCV deficit in patients with POTS. The negative correlation between BV deviation and upright HR indicates that hypovolemia is one of the pathophysiological causes of POTS. Correlations between body impedance and CO rebreathing volume suggest its usefulness for measurements of volume changes.

Indexed as

Blood VolumeCarbon MonoxidePostural Orthostatic Tachycardia SyndromeAdultBreath TestsFemaleHumansMaleMiddle AgedYoung AdultCarbon MonoxideBlood volumeCarbon monoxide rebreathingPlasma volumePostural orthostatic tachycardia syndromeRed blood cell volume

Identifiers

PMID39614968
PMCPMC11999789

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.