Melatonin Reduces Tachycardia in Postural Tachycardia Syndrome: A Randomized, Crossover Trial

作者：Green Elizabeth A; Black Bonnie K; Biaggioni Italo; Paranjape Sachin Y; Bagai Kanika; Shibao Cyndya; Okoye Mirian C; Dupont William D; Robertson David; Raj Satish R^*

来源：Cardiovascular Therapeutics, 2014, 32(3): 105-112.

DOI：10.1111/1755-5922.12067

• Autonomic nervous system
• Drugs
• Melatonin
• Orthostatic intolerance
• Sympathetic nervous system
• Tachycardia

BackgroundPostural tachycardia syndrome (POTS) induces disabling chronic orthostatic intolerance with an excessive increase in heart rate (HR) upon standing, and many POTS patients have a hyperadrenergic state. Medications that restrain HR are a promising approach to this problem.
ObjectiveWe tested the hypothesis that melatonin will attenuate the tachycardia and improve symptom burden in patients with POTS.
MethodsPatients with POTS (n=78) underwent acute drug trials with melatonin 3mg orally and placebo, on separate mornings, in a randomized crossover design. Blood pressure, HR, and symptoms were assessed while seated and after standing for up to 10min prior to, and hourly for 4h following study drug administration.
ResultsThe reduction in standing HR was significantly greater 2h after melatonin compared with placebo (P=0.017). There was no significant difference in the reduction of systolic blood pressure between melatonin and placebo, either with standing or while seated. The symptom burden was not improved with melatonin compared with placebo.
ConclusionOral melatonin produced a modest decrease in standing tachycardia in POTS. Further research is needed to determine the effects of regular night-time use of this medication in POTS.

• 出版日期2014-6