Research topics: General Articles and Research Overviews, Immune System Research, Viral Research, Cardiac Research, Exercise Research, Muscle Research, Metabolic Research, Neurological and Cognitive Research, Genetic Research, Neuroendocrine Research, and Miscellaneous Research.
Article topics: The Definitions of M.E., On 'fatigue', CBT, GET and the unscientific 'behavioural' paradigm of M.E., On 'stress', M.E. Outbreaks, On the Name Myalgic Encephalomyelitis, M.E. and Other Illnesses, Children with M.E., The Severity of M.E., M.E. Fatalities, Activism Articles, Articles sorted by Author, Articles sorted by Country and Historical, Political and Medical Overviews.
Topic on this page: Cardiac and Cardiovascular Research - page 3 of 3
Possible cell membrane transport defect in chronic fatigue syndrome? Watson WS, McCreath GT, Chaudhuri A, Behan P. Journal of Chronic Fatigue Syndrome 1997; 3(3): 1-13.
Abstract: Cardium thallium-201 single photon emission computerised tomography has been carried out in 10 adult patients with chronic fatigue syndrome. Seven of the patients had defects in the thallium tracer distribution within the left ventricle; this was significantly greater than would have been expected in a normal adult population. Similar abnormal scans have been observed in patients with syndrome X, a condition which has system overlap with chronic fatigue syndrome. It has been suggested that an abnormally high efflux of cellular potassium may be the cause of the abnormal scans in syndrome X, and it is proposed that this mechanism may also have a role to play in chronic fatigue syndrome.
"Baroreceptor Reflex and Integrative Stress Responses in Chronic Fatigue Syndrome." Arnold Peckerman, PhD, John J. LaManca, PhD, Bushra Qureishi, MD, Kristina A. Dahl, MD, Roseli Golfetti, PhD, Yoshiharu Yamamoto, PhD and Benjamin H. Natelson, Psychosomatic Medicine 65:889-895 (2003)
OBJECTIVE: Altered cardiovascular responses to mental an postural stressors have been reported in chronic fatigue syndrome (CFS). This study examined whether those findings may involve changes in baroreceptor reflex functioning. METHODS: Chronotropic baroreceptor reflex (by sequential analysis) and cardiovascular stress responses were recorded during postural (5-minute of active standing) and cognitive (speech task) stress testing in patients with CFS grouped into cases with severe (N = 21) or less severe (N = 22) illness, and in 29 matched control subjects. RESULTS: Patients with CFS had a greater decline in baroreceptor reflex sensitivity (BRS) during standing, although only those with severe CFS were significantly different from the controls. Systolic blood pressure declined during standing in the control group but was maintained in the CFS patients. In contrast, the patients with less severe CFS had blunted increases in blood pressure during the speech task, which could not, however, be explained by inadequate inhibition of the baroreceptor reflex, with all groups showing an appropriate reduction in BRS during the task.CONCLUSIONS: These results indicate that in CFS, deficiencies in orthostatic regulation, but not in centrally mediated stress responses, may involve the baroreceptor reflex. This study also suggests that classifying patients with CFS on illness severity may discriminate between patients with abnormalities in peripheral vs. central mechanisms of cardiovascular stress responses.
Abnormal left ventricular myocardial dynamics in eleven patients with chronic fatigue syndrome. Dworkin HJ, Lawrie C, Bohdiewicz P, Lerner AM. Clinical Nuclear Medicine 1994; 19(8): 675-7.
Abstract: Eleven patients diagnosed with chronic fatigue syndrome were found to have abnormal left ventricular myocardial dynamics as indicated on MUGA studies. Among the abnormalities noted were low EF at rest or stress (3/11), dilatation of the left ventricle (5/11), and segmental wall motion abnormalities (7/11). One patient had elevated CPK and flat EF response to exercise.
Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome Rowe PC, Barron DF, Calkins H, Maumenee IH, Tong PY, Geraghty MT Departments of Pediatrics and Medicine and the Center for Hereditary Eye Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Journal of Pediatrics 1999 Oct;135(4):494-499 (ISSN0022-3476) NLM citation: PMID: 10518084
Reprint requests: Peter C. Rowe, MD, Brady 212, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. Copyright © 1999 by Mosby, Inc.
The authors studied the connection between CFS, Ehlers-Danos Syndrome and orthostatic intolerance in a group of adolescent clinic patients. Because of the overlap they found, they suggest that "a careful search for hypermobility and connective tissue abnormalities should be part of the evaluation of patients with CFS and orthostatic intolerance syndromes." The abstract can be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10518084&form=6&db=m&Dopt=b
For information on Ehlers-Danos Syndrome, see http://www.ednf.org/ and http://www.stepstn.com/cgi-win/nord.exe?proc=GetDocument&rectype=0&recnum=240
Orthostatic intolerance, a common symptom in CFS, is the general inability to be upright for any length of time without various symptoms, including lightheadedness, dizziness, fainting, and nausea. The most well-publicized type of OI is neurally-mediated hypotension (NMH), but many people with OI do not test positive for blood pressure abnormalities.
Cardiovascular response to upright tilt in fibromyalgia differs from that in chronic fatigue syndrome Naschitz JE, Rozenbaum M, Rosner I, Sabo E, Priselac RM, Shaviv N, Ahdoot A, Ahdoot M, Gaitini L, Eldar S, Yeshurun D. J Rheumatol 2001 Jun;28(6):1356-60
Departments of Internal Medicine A, Rheumatology, Anesthesiology, and Surgery, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel PMID: 11409131
OBJECTIVE: To compare the cardiovascular response during postural challenge of patients with fibromyalgia (FM) to those with chronic fatigue syndrome (CFS).
METHODS: Age and sex matched patients were studied, 38 with FM, 30 with CFS, and 37 healthy subjects. Blood pressure (BP) and heart rate (HR) were recorded during 10 min of recumbence and 30 min of head-up tilt. Differences between successive BP values and the last recumbent BP, their average, and standard deviation (SD) were calculated. Time curves of BP differences were analyzed by computer and their outline ratios (OR) and fractal dimensions (FD) were measured. HR differences were determined similarly. Based on the latter measurements, each subject's discriminant score (DS) was computed.
RESULTS: For patients and controls average DS values were: FM: -3.68 (SD 2.7), CFS: 3.72 (SD 5.02), and healthy controls: -4.62 (SD 2.24). DS values differed significantly between FM and CFS (p < 0.0001). Subgroups of FM patients with and without fatigue had comparable DS values.
CONCLUSION: The DS confers numerical expression to the cardiovascular response during postural challenge. DS values in FM were significantly different from DS in CFS, suggesting that homeostatic responses in FM and CFS are dissimilar. This observation challenges the hypothesis that FM and CFS share a common derangement of the stress-response system.
A measure of heart rate variability is sensitive to orthostatic challenge in women with chronic fatigue syndrome. Yamamoto Y, LaManca JJ, Natelson BH. Department of Neurosciences, New Jersey Medical School, East Orange, New Jersey 07018-1095, USA.
The use of symptoms generated by head up tilt (HUT) is not a useful tool in identifying chronic fatigue syndrome (CFS). We investigated whether heart rate variability (HRV) assessed early during HUT might be useful. A sample of 46 female subjects (24 with CFS and 22 sedentary, age-matched healthy controls; CON) who had exhibited no difference in time to syncope during tilt was examined for HRV responses to 10 min of 70 degrees HUT after 5 min of baseline in the supine position. HRV data were analyzed by the method of coarse graining spectral analysis. Variables compared between groups included mean and standard deviation (SD(RRI)) of RR intervals (RRI), amplitudes of low- (A(LF); 0.04-0.15 Hz) and high-frequency (A(HF); >0.15 Hz) harmonic as well as aperiodic, fractal (A(FR); 1/f(beta)) spectral components, the spectral exponent beta, and the difference in these values between baseline and HUT for each subject. In the supine baseline, only mean RRI was significantly (P < 0.01) lower in CFS than in CON. During HUT, however, mean RRI (P < 0.01), SD(RRI) (P < 0.01), A(HF) (P < 0.05), and A(FR) (P < 0.01) were significantly lower in CFS than in CON. When the difference in values between baseline and HUT for each subject was examined, only the difference for A(FR) (deltaA(FR)) was significantly (P < 0.01) lower in CFS than in CON, suggesting that A(FR)is a disease-specific response of HRV to HUT. When a cut-off level was set to deltaA(FR) = -2.7 msec, the sensitivity and the specificity in differentiating CFS from controls were 90% and 72%, respectively. The data suggest that a decrease in aperiodic fractal component of HRV in response to HUT can be used to differentiate patients with CFS from CON.
The objective was to determine the nature of autonomic and vasomotor changes in adolescent patients with orthostatic tachycardia associated with the chronic fatigue syndrome (CFS) and the postural orthostatic tachycardia syndrome (POTS).
Continuous electrocardiography and arterial tonometry was used to investigate the heart rate and blood pressure responses before and 3-5 min after head-up tilt in 22 adolescents with POTS and 14 adolescents with CFS, compared with control subjects comprising 10 healthy adolescents and 20 patients with simple faint. Heart rate and blood pressure variability, determined baroreceptor function using transfer function analysis, and measured cardiac vagal and adrenergic autonomic responses were calculated using timed breathing and the quantitative Valsalva maneuver.
Two of 10 healthy controls and 14 of 20 simple faint patients experienced vasovagal syncope during head-up tilt. By design, all CFS and POTS patients experienced orthostatic tachycardia, often associated with hypotension. R-R interval and heart rate variability were decreased in CFS and POTS patients compared with control subjects and remained decreased with head-up tilt. Low-frequency (0.05-0.15 Hz) blood pressure variability reflecting vasomotion was increased in CFS and POTS patients compared with control subjects and increased further with head-up tilt.
This was associated with depressed baroreflex transfer indicating baroreceptor attenuation through defective vagal efferent response. Only the sympathetic response remained. Heart rate variability declined progressively from normal healthy control subjects through syncope to POTS to CFS patients. Timed breathing and Valsalva maneuver were most often normal in CFS and POTS patients, although abnormalities in select individuals were found.
Heart rate and blood pressure regulation in POTS and CFS patients are similar and indicate attenuated efferent vagal baroreflex associated with increased vasomotor tone. Loss of beat-to-beat heart rate control may contribute to a destabilized blood pressure resulting in orthostatic intolerance. The dysautonomia of orthostatic intolerance in POTS and in chronic fatigue [syndrome] are similar.
Cardiac abnormalities in ME/ICD-CFS
Information about ME and the heart from the ME society of America
CFS Can Cause A Particular Type Of Heart Murmur
Myalgic encephalomyelitis: postviral fatigue and the heart. NR Grist. BMJ 1989:299:12-19
Arguments for a role of abnormal ionophore function in chronic fatigue syndrome (Syndrome X). A Chaudhuri et al. In: Chronic Fatigue Syndrome. Ed: Yehuda and Mostotsky pub. Plenum Press, New York 1997
Cardiovascular response during head-up tilt in chronic fatigue syndrome. La Manca JJ, Natelson BH et al Physiol 1999:19:2:111-120
The Doctor's Guide to CFIDS by David S. Bell MD
A Parents Guide to CFIDS by David S. Bell MD
The Disease of a Thousand Names by David S. Bell MD
ME: The New Plague by Jane Colby
America's Biggest Cover-Up: 50 More Things Everyone Should Know About The Chronic Fatigue Syndrome Epidemic And Its Link To AIDS by Neenyah Ostrom
The Polio Paradox: Understanding and Treating "Post-Polio Syndrome" and Chronic Fatigue [Syndrome] by Richard L. Bruno