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Heart Disease Health Center

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Exercise May Help Treat POTS Heart Condition

Study Shows Exercise Program Is Effective for Heart Condition Also Known as 'Grinch Syndrome'

Exercise Program for Grinch Syndrome continued...

Before the exercise part of the study, the patients were randomly assigned to take a beta-blocker drug, propranolol, or a placebo. The beta-blocker is given to reduce the rapid heartbeat.

But Levine's team wanted to find out if reconditioning the patients with the exercise would improve the condition and make the medications unnecessary.

After the medication phase, the researchers found that those on the beta-blockers had no changes in social function scores. Very few had improved physical function scores.

At the beginning of the three-month exercise program, patients worked out on recumbent equipment such as rowers or bikes or they swam. "We started with about three or four times a week, about 25 to 35 minutes including warm-up and cool-down," says study researcher Qi Fu, MD, PHD. She is an assistant professor of medicine at the University of Texas Southwestern Medical Center and a researcher at the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital.

"By the end of three months, they were exercising about five or six hours a week," she says. Besides cardiovascular exercise, they added weight and resistance training. Patients could work out upright as they progressed.

Both the beta-blocker and the exercise training lowered the standing heart rate.

But the patients' quality-of-life scores, including social and physical functioning, were better after the exercise phase but not after the beta-blocker phase.

"Beta-blockers slow the heart rate," Levine says. "Doctors love to see that outcome [so] they prescribe beta-blockers. The problem is, it's not the heart rate that is the issue. And that I think is our message: Just slowing the heart rate doesn't make people feel better."

The exercise worked better than the medicine to restore upright blood circulation, improve kidney function and quality of life, all problems in POTS, the researchers say.

By the end of the exercise phase, 10 patients no longer met the criteria for the syndrome.

In those with POTS, Levine says, "this isn’t a pathologically small heart, it's a variation of normal."

Grinch Syndrome: One Woman's Story

Krakower calls the study findings exciting. But she is not certain everyone will benefit. She cites disagreement among the medical community about various other problems besides the heart size and condition that can play into having the condition.

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