Abstract 4141532: Time-Restricted Eating Improves Heart Rate, Symptoms, and Quality of Life Metrics in Patients With Postural Orthostatic Tachycardia Syndrome

Introduction/Hypothesis: Time-restricted eating (TRE) is a lifestyle intervention in which there is an extended fasting period overnight of about 14 hours with a 10-hour eating window. Clinical and animal studies have shown that TRE decreases inflammation, and improves immune autonomic and mitochondrial function and cardiometabolic parameters. Patients with POTS have derangements in many of these parameters resulting in the hypothesis that TRE could be beneficial for patients with POTS. Methods/Approach: 20 participants aged 18-70 (M=36 years ±11.79), all on pharmacological therapy for POTS, met inclusion criteria: ≥12-hour dietary window and established POTS diagnosis (≥30 bpm increase in upright heart rate). After a 2-week baseline period of monitoring via myCircadianClock App, to ensure baseline eating window was ≥12 hours, participants entered a 12-week TRE intervention, consuming calories within an 8-10 hour eating window. Pre/post-intervention assessments included a 10-minute stand test and QOL questionnaires (SF-36 and MALMO POTS). Results/Data: Orthostatic assessments comparing pre and post-intervention standing tests revealed reduction in heart rate increase. 19 of the 20 participants experienced this improvement, with the mean decrease in heart rate change (Figure 1A) averaging approximately 11 bpm (p < 0.001). Additionally, outcomes from the MALMO POTS Symptom Score Survey (MALMO) (Figure 1B) and the Short Form (36) Health Survey (SF-36) showcased substantial enhancements in participants' QOL. These improvements were evidenced by reductions in POTS symptom severity (p < 0.0001) and notable enhancements in physical functioning (p = 0.015) and energy/fatigue levels (p < 0.01). Conclusion: In this pilot study, TRE improved heart rate, symptoms and QOL in patients with POTS, who are on background medical therapy, suggesting this lifestyle intervention could be beneficial for patients with POTS.