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Links to studies on heart function in CFS


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  • 7 years later...


For those of you who aren't aware, CFS and POTS have some common symptoms. So any research on CFS may benefit those with POTS ... OR dysautonomia in this case ...

I just found Peckerman's interview on cardiac dysfunction in PWCs (persons with CFS) ... below ... and then noticed it was mentioned here once too.

Based on my experience with OI over the last 3 or 4 years, I'd say Peckerman is right. I've been trying to explain why I get the feeling that blood rushes back into the upper part of my body for a few years now and here it was all along.

It's good to see that he understands that just getting the blood back into those organs isn't going to fix the problem immediately. It takes time for those organs to recoop from the blood loss ... And that's why it takes me an hour after laying down to recooperate ... He calls this hypoperfusion ...

tc ... d


Fall 2003

Research Q&A

Cardiac Output Linked to Severe CFS Cases

By Mark Giuliucci

Article: “Abnormal Impedance Cardiography Predicts Symptom Severity in Chronic Fatigue Syndrome.” The American Journal of the Medical Sciences. 2003; 326(2):55-60.

Synopsis: While the cause of chronic fatigue syndrome (CFS) remains unknown, researchers have noted circulatory irregularities in many patients.

These include autonomic nervous system dysfunction, often manifested as orthostatic intolerance; neuroendocrine abnormalities (see story on p. 4); reduced plasma volume; and low red blood cell mass. In combination, some researchers believe, these factors could create deficiencies in blood flow to organs and muscles — with resultant symptoms, such as post-exertional fatigue, that are hallmarks of CFS.

New research from the CFS Cooperative Research Center at the University of Medicine and Dentistry of New Jersey has tested the possible link between CFS symptoms and cardiac output (the amount of blood pumped by the heart each minute).

Thirty-eight CFS patients participated in the study, along with 27 matched, sedentary controls. All subjects were tested for cardiac output using impedance cardiography, a noninvasive procedure based on the principle that electrical impedance of tissues is proportional to their blood flow. Subjects were tested during a 10-minute resting supine period and a five-minute quiet standing period.

Results showed that patients with severe cases of CFS (those who had more symptoms and rated them as substantial or greater in severity) had significantly lower cardiac output than either controls or patients with less-severe CFS — even though mean arterial blood pressure and heart rate did not vary significantly among the groups. Moreover, post-exertional fatigue and flu-like symptoms were predictive of lowered cardiac output (p< 0.0002).

The authors say their work suggests that “in some patients with CFS, blood pressure is maintained at the cost of restricted flow, possibly resulting in a low flow circulatory state.” CFS patients with lower cardiac output may not be able to meet the demands of everyday physical activities, leading to fatigue and other symptoms.

Lead author Arnold Peckerman, PhD, discusses the study’s findings:

Q: What led to the hypothesis that CFS patients may have reduced cardiac output?

Dr. Peckerman: Many of the symptoms of CFS, such as post-exertional fatigue, are also symptoms of low cardiac output.

A person can have low cardiac output for a number of reasons, but the result is the same — circulation slows down and some organs may not get enough blood flowing through them.

If cardiac output falls to the point that it is unable to meet metabolic demands, this is called hypoperfusion.

Clinical signs of hypoperfusion include lowering of pulse pressure, cool extremities, altered mentation, rapid resting heart rate, breathing that alternates between deep and shallow, and high blood urea nitrogen relative to creatinine. To be sure, most CFS patients do not show clinical signs of hypoperfusion, and they couldn’t.

If you have symptoms like these, you get referred for cardiological evaluation and treated appropriately. You would not be diagnosed with CFS.

The point I am making is that the criteria for defining hypoperfusion are conservative. However, if you lower the bar, meaning you entertain a possibility that reduction in blood flow of a lesser degree than that may still be clinically significant, and you pull together the many indications from different research and clinical observations in CFS pointing in this direction, it becomes a reasonable question to ask.

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I found these videos on youtube. These are from a study conducted by Marvin Medow, PHD on blood flow in POTS/CFS. I'm not sure where this was done or who else was involved.

Hypoperfusion and vasonstriction in POTS/CFS

I've only watched the first 2. The part I found most interesting here on the first video was at the 7:40 mark. He refers to how our skin depending on our temperature can be a major resevoir of blood ...

tc ... d

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