POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME (POTS) AND CARDIAC REHABILITATION:CLINICAL SUCCESSES AND CHALLENGES.
Bibliographic record
Abstract
Postural Orthostatic Tachycardia Syndrome (POTS) is a chronic debilitating form of dysautonomia most prevalent in premenopausal women. POTS continues to be poorly understood, however evidence suggests exercise and lifestyle interventions may ameliorate symptoms such as fatigue pre-syncope, and exercise intolerance and may in some patients induce remission. A recent position statement on POTS recommends exercise and lifestyle modification as a first line non-pharmacological strategy and cardiac rehabilitation (CR) is increasingly prescribed for this purpose. PURPOSE: To describe the experience of a gender-specialized CR program for patients with POTS. METHODS: A retrospective case review was undertaken to describe the demographics and outcomes of women living with POTS who attended CR from 2016-2019. RESULTS: Baseline characteristics showed 42 women aged 18-62 years (mean± SD, 35 ± 13.02), 62% unemployed and 68% exhibiting below average age-predicted fitness in Metabolic Equivalents (METS ml/min/kg,(9.7 ± 10.42) and poor function on the Duke Activity Status Index (9.7 ± 10.4). Quality of life as measured by the Short Form 36 physical component score (27.7 ± 6.6) were significantly lower than expected while the mental component score was average (45.0 ±7.7). 50% of participants had mild depression while 31% had moderate to severe depression on the Beck Depression Inventory (15.9 ± 9.0). Of those, 62% (n=26) of participants attended onsite CR, 33% (n=14) of patients opted for an exercise consult or a home program. Despite personalized programs with recumbent aerobic exercise, lifestyle education, young women’s peer support, dietitian and pharmacy counseling, completing CR was challenging. Adherence rates to the weekly onsite CR sessions were low due to on-going symptoms of postural intolerance, however, only a small number who elected to participate did not complete the CR program (n=2). CONCLUSIONS: Patients with POTS have impaired quality of life with low fitness, high levels of unemployment and depression. There is early evidence that a traditional CR model may be more of a challenge in women with POTS and a needs assessment is warranted. Additional components of CR such as peer support, stress management, and self-care strategies may be important to enhance the therapeutic efficacy of this intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".