Abstract
The purpose of this study was to determine whether chronic fatigue syndrome (CFS)
patients show autonomic dysfunction at the cardiac level and if so, to discover whether
these abnormalities explain the fatiguability and/or other symptoms in CFS. The study
population consisted of 21 CFS patients (Centers for Disease Control and Prevention
[CDC] criteria, 1988) and 13 age- and sex-matched healthy controls. The autonomic
testing consisted of: (1) postural challenge: registration of heart rate and blood
pressure (BP) and heart rate variability in supine and in upright position (tilted
to 70°); (2) Valsalva maneuver; (3) handgrip test; (4) cold pressor test; and (5)
heart rate response to deep breathing. Statistical analysis was performed using the
Mann Whitney rank sum test; results of the test were considered significant at the
0.05 level. After tilting heart rate was significantly higher in CFS patients compared
with healthy controls (mean CFS = 88.9 beats/min vs control = 77.9 beats/min; P <0.01). Low frequency power after tilting was significantly higher in CFS patients
compared with controls (mean CFS = 0.603 vs control = 0.428; P = 0.02). There was a trend toward an increased heart rate during the cold pressor
test. Other parameters did not differ between the CFS and control populations. The
observed changes point toward a sympathetic overactivity in CFS patients when they
are exposed to stress. Parasympathetic abnormalities could not be observed. Therefore,
our findings provide no real explanation for the fatigue and intolerance to physical
exertion in these patients.
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References
- Chronic fatigue syndrome.Ann Intern Med. 1988; 108: 387-389
- Signs and symptoms of chronic fatigue syndrome.Rev Infect Dis. 1991; 13: S8-S11
- The chronic fatigue syndrome.J Rheumatol. 1989; 16: 23-27
- Is neurally mediated hypotension an unrecognised cause of chronic fatigue?.Lancet. 1995; 345: 623-624
- The relationship between neurally mediated hypotension and the chronic fatigue syndrome.JAMA. 1995; 274: 961-967
- Vagal tone is reduced during paced breathing in patients with the chronic fatigue syndrome.Clin Autonom Res. 1995; 5: 139-143
- Cardiac function at rest and with exercise in the chronic fatigue syndrome.Chest. 1989; 95: 779-784
- Exercise performance and fatiguability in patients with chronic fatigue syndrome.J Neurol Neurosurg Psychiatry. 1993; 56: 993-998
- Aerobic work capacity in patients with chronic fatigue syndrome.BMJ. 1990; 301: 953-956
- Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis.J Auton Nerv Syst. 1996; 60: 115-120
- Investigation of autonomic disorders.in: Bannister R. Mathias C. Autonomic Failure. Oxford Medical Publications, Oxford1993: 258-269
- Sympathetic overactivity in subjects complaining of unexplained fatigue.Clin Sci. 1994; 87: 655-661
- Parasympathetic cardiovascular control in human disease.Am J Physiol. 1980; 239: H581-H593
- Analysis of heart rate variability.in: Bannister R. Mathias C. Autonomic Failure. Oxford Medical Publications, Oxford1993: 323-333
Article Info
Publication History
Published online: August 16, 2004
Identification
Copyright
© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
