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Record W4414162867 · doi:10.1016/j.jaccas.2025.105430

Exacerbation of Postural Orthostatic Tachycardia Syndrome With Tirzepatide Prescribed for Weight Loss

2025· article· en· W4414162867 on OpenAlexafffund
Eric T. Hedge, Shannon R Grappe, Steven Vernino, Jaime P. Almandoz, Benjamin D. Levine

Bibliographic record

VenueJACC Case Reports · 2025
Typearticle
Languageen
FieldMedicine
TopicCardiovascular Syncope and Autonomic Disorders
Canadian institutionsResearch Institute for Aging
FundersNational Heart, Lung, and Blood InstituteCanadian Institutes of Health ResearchNational Institutes of Health
KeywordsPostural Orthostatic Tachycardia SyndromeOrthostatic intoleranceExacerbationWeight lossOrthostatic vital signsTachycardia

Abstract

fetched live from OpenAlex

BACKGROUND: Prescription of obesity medications is increasing, but our understanding of their effects in patients with cardiovascular disorders, such as postural orthostatic tachycardia syndrome (POTS), is limited. CASE SUMMARY: POTS was exacerbated in a 28-year-old woman with obesity after using tirzepatide for weight reduction. Her condition was effectively treated with progressive exercise training and counseling, which reduced supine and standing heart rates to normal values, before starting tirzepatide. However, while using tirzepatide, the patient's supine and standing heart rates were markedly elevated, and she experienced recurrence of orthostatic intolerance symptoms. DISCUSSION: Although small increases in resting heart rate with glucagon-like peptide-1 receptor agonist use have been reported in adults (approximately 3 beats/min), such a large increase in both supine and standing heart rate (20-30 beats/min) with tirzepatide has not been reported to our knowledge. TAKE-HOME MESSAGE: Prescription of tirzepatide may exacerbate symptoms of orthostatic intolerance and cause marked tachycardia in patients with POTS.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.075
Threshold uncertainty score0.492

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.006
GPT teacher head0.248
Teacher spread0.242 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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