| *O* Dr Paul Cheney 'The Heart of the Matter': cardiac and vascular abnormalities (and cardiomyopathy) in ME/ICD-CFS 2005
"Now, do CFIDS patients prefer to stand up or lie down? Of course, they prefer to lie down. Do you know why? "Do you know what your cardiac output does when you stand up? It drops 30%. In all humans, without exception. So very critical to this technology is that it's the only one that could be done upright [again, four positions on the tilt table are best; standing up and laying down at a minimum]. And what they found is absolutely astonishing, truly astonishing. When [disabled CFIDS patients] stand up, [they're] on the edge of organ failure due to low cardiac output."
CFS Compensates for Idiopathic Cardiomyopathy "Let me first of all define heart failure. There are two kinds of heart failure. There's the kind that any cardiologist can diagnose in about a minute. That you do NOT have. Which is why cardiologists missed this. What you have is Compensated Idiopathic Cardiomyopathy." [Idiopathic: cause unknown; Cardiomyopathy: structural or functional disease of heart muscle] "And your primary means of compensation—now this is the big twist—are you ready? Have you got your seat belt on? The primary methodology for compensation for this disorder is in fact CFS itself."
The Peckerman article Dr. Cheney refers to is available free online.
"Peckerman's research team at the VA Medical Center in East Orange, N.J., used a sophisticated test to measure how well the heart pumps blood. They gave the test to 16 chronic fatigue syndrome patients, both before and after they exercised. They also tested four non-athletic volunteers. All of the patients' and volunteers' hearts' pumped normally during rest. After exercise, however, 13 of the 16 chronic fatigue [syndrome] patients' hearts pumped less blood than they did at rest.
"Basically we are talking about heart failure," Peckerman tells WebMD. "But chronic fatigue syndrome is a progressive disease. If we were able to detect this in its early stages, it is quite possible there might be a way to treat it."
"Chronic Fatigue Syndrome: The Heart of the Matter" a seminar by Dr Paul R. Cheney, M.D., Ph.D.
September 9th, 2006
During his three-hour presentation, Dr. Cheney discussed his latest research and treatment findings. These include (but are not limited to):
**Diastolic Dysfunction in CFS
Due to a lack of energy at the cellular level the hearts of CFS patients don't fill properly with blood; this is further complicated when patients stand. Ninety-nine percent of Dr. Cheney's CFS patients test positive for diastolic dysfunction via echocardiograms (sonograms of the heart).
**Patent Foramen Ovales in CFS
A PFO is a flap-valve that allows blood to flow between the two upper chambers of the heart. Present in babies before they are born, it usually seals shut after birth but remains in up to 20% of normal adults in whom it can open under certain rare conditions. PFO's are unusually common in CFS, with up to 80% of patients testing positive. The presence of a PFO in CFS can be very problematic. The underlying reason for the increase in PFO's in CFS may be the underlying energy deficits at the cellular level. Dr. Cheney believes that PFO closure in CFS poses certain risks and there are indications that his treatment protocol may make such a procedure unnecessary for most patients.
**Therapeutic Responses to Cellular Energy Therapy as Measured by Echocardiography
Dr. Cheney's current research treatment protocol is designed to increase cellular energy production by restoring the function of energy systems inside cells. The pre-treatment phase of the study improves certain enzyme functions that are necessary for the safe production of energy. The pre-treatment phase also protects vital organs and modulates the immune system. One way Dr. Cheney is measuring the effectiveness of the treatment protocol is by doing sonograms of the heart before and after
the treatment.
**Oxygen therapy in CFS
Oxygen appears to be a blessing and a curse, depending upon the dose. Low dose oxygen appears to improve cardiac function, which has been
demonstrated by echocardiographic parameters sensitive to cellular energetics. However, higher doses of oxygen appear to cause significant toxicity to the heart in general and to the main pumping chamber in particular. This unusual sensitivity to oxygen toxicity appears related to the nature of the underlying defects responsible for reduced cellular energy.
The Speaker
Dr. Cheney was one of the doctors who recognized an outbreak of "something" in Incline Village at Lake Tahoe in 1984 and called in the CDC. He has treated approx. 5000 patients with CFIDS from at least 48 states and 15 countries. He has published numerous articles in peer reviewed medical journals and lectured around the world on the subject of CFS. Dr. Cheney has authored or co-authored publications and scientific presentations in many fields relevant to CFS, including immunology, virology, clinical epidemiology, metabolism, neuropsychology, neuroendocrinology, and exercise physiology. He currently practices in Asheville, NC.
DVD 2-disc set
The event was taped and we are now selling a DVD 2-disc set. Click here for purchasing information.
A talk by Dr Cheney; CFS and Diastolic Cardiomyopathy
FREE ONLINE 2005 VERSION (Note that this is NOT the far more advanced 2006 version and does not contain the treatment section as seen in the 2006 version)
A three-hour talk in streaming video for viewing on the Web [with a broadband connection only, not a dial-up connection.] From the ME society of America.
Click on this link to view/download the 2005 video "CFS and Diastolic Cardiomyopathy"
To purchase a video cassette or DVD of the updated 2006 seminar by Dr. Cheney from the Dallas-Fort Worth group, Click here
Note: See the Cardiac Insufficiency Hypothesis page on the ME Society of America website for more information and links relevant to this topic.
A Summary of the Cheney DVD 'The Heart of the Matter' by Maraget Williams, 10th November 2006
'Magnetic Resonance Imaging
· 78% of patients have punctate lesions which are most consistent with small strokes and there is evidence to support this (ie. they are not caused by a virus or by inflammation).
Mixed venous blood gas picture
· PvO2 is 25 (it should be 40)
· PvCO2 is 55 (it should be 45)
This is a differential hypoxia with hypercarbia. There are only two diseases where this is seen: one is pulmonary hypertension; the other is (ME)CFS.
The arterial side is normal.
Where does the oxygen go? It’s being transported somewhere, but not to the mitochondria. (ME)CFS patients have been shown to have increased pooling of extra-cellular fluid in the belly, pelvis and legs which might contain this dissolved oxygen, but it is more likely being consumed by the oxidative pathway to create superoxide in massive amounts. Superoxide is the progenitor of all free radicals. The consequences are increased intra-cellular oxdidative stress.
If you intervene and give Prozac, you up-regulate superoxide, which is why serotinergic drugs kill neurons.
Intervening with drugs in situations not fully understood breeds chaos and kills patients.
(ME)CFS as cellular metabolic dysfunction
There are problems at cell level in energy production, and because of this degraded energy problem, patients suffer a defect in the ability to detoxify toxins, especially in the portal circulation (giving rise to gut toxicity as seen in phase 2). Gene alterations (seen in phase 4) generate a massive disturbance in the development of energy at the cell level. If you lose energy, you lose glutathione, but the more glutathione you give, the more you just create oxidised glutathione, which generates loss of citrate, causing a left shift on oxyhaemoglobin desaturation. Citrate also binds to magnesium, so over time the patient will develop a severe magnesium depletion syndrome. When that happens, you’ve had your last good night’s sleep: when you lose magnesium, you can’t sleep any more.
How and why would a low energy state lead to an inability to transfer oxygen? Cheney concludes that it’s part of a bigger picture that uses low oxygen transport to stablise the system.
In (ME)CFS, these serious issues are a big problem, especially in the brain, the heart and in muscle. (ME)CFS is a compensatory response to down-regulate energy production and oxygen transport in order to reduce tissue damage.
Attempts to push beyond energy limits will cause injury.'
[This summary is taken from the full-length article: Klimas, Wessely and NICE: Redefining CBT?]
CFS, Heart Problems, and a Risky Procedure: A Warning from Dr. Cheney by Carol Sieverling, reviewed and edited by Paul R. Cheney, M.D., Ph.D.
I had a relatively brief appointment with Dr. Cheney at the end of June. He is very concerned that the CFS community will hear that he has detected a heart problem called Patent Foramen Ovale (PFO) in a significant number of his patients, and that as a result, many CFS patients will pursue a corrective procedure that is potentially very dangerous. He asked me to write an article informing CFS patients about the risks of undergoing a catheterization procedure to close a PFO or Atrial Septal Defect (ASD).
Oxygen Toxicity as a Locus of Control for Chronic Fatigue Syndrome Paul R. Cheney MD, PhD 2008
Cell Associated Therapy for Chronic Fatigue Syndrome: Is this the Next Frontier? Paul R. Cheney MD, PhD 2008
From: DFW CFIDS <dfwcfids58@TX.RR.COM> Paul Cheney's Presentation at IFM conference 2008
Paul Cheney, MD, PhD was the opening speaker at the 15th International Symposium of Functional Medicine in Carlsbad, CA on Thursday, May 22. He spoke for almost three hours.
His presentation, "Chronic Fatigue Syndrome, Oxidative Stress, and Pain: A Physician's Personal and Professional Journey Through the Functional
Medicine Model" received a five-minute standing ovation from the over 600 physicians and researchers in attendance from 14 countries.
The Institute of Functional Medicine will be offering a DVD for sale of Dr. Cheney's voice synchronized to his PowerPoint presentation. This should be ready within 30 to 60 days through the IFM. (www.functionalmedicine.org.) I want to emphasize that this DVD will only be available through the Institute of Functional Medicine at the above website. The cost is unknown at this time.
His presentation included two research astracts that will be posted separately. One is "Cell Associated Therapy for CFS" and the other is "Oxygen Toxicity as the Locus of Control in CFS".
Carol Sieverling
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