Saturday, December 8, 2018

Cardiac abnormalities in ME/CFS not due to deconditioning

MEA Summary Review: Cardiac abnormalities in ME/CFS not due to deconditioning

<https://www.meassociation.org.uk/2018/11/mea-summary-review-cardiac-abnormalities-in-me-cfs-not-due-to-deconditioning-26-november-2018/>

MEA Summary Review: Cardiac abnormalities in ME/CFS not due to
deconditioning | 26 November 2018


Charlotte Stephens, Research Correspondent, ME Association.

Introduction

Click to download our 7-page summary review.

Linda van Campen and Frans Visser from the Netherlands have just
published a study
<https://www.gavinpublishers.com/articles/Research-Article/Journal-of-Thrombosis-and-Circulation/The-Abnormal-Cardiac-Index-and-Stroke-Volume-Index-Changes-During-a-Normal-Tilt-Table-Test-in-ME-CFS-Patients-Compared-to-Healthy-Volunteers-are-Not-Related-to-Deconditioning>
that examined stroke volume and cardiac output in ME/CFS. It confirmed
earlier findings from a smaller study that changes occurred in these
two key cardiac measures despite normal tilt-table results (Timmers et
al., 2002).

Both studies found reduced cardiac output and stroke volumes during a
tilt table test in ME/CFS patients compared to healthy controls.
However, these patients had normal tilt table results, meaning their
heart rate and blood pressure did not change significantly enough to
be diagnosed with orthostatic intolerance.

The authors of the earlier study suggested that these findings were
due to deconditioning, but in this new, larger study, Van Campen and
Visser showed they were not as they found no difference in results
between different disease severities.

If it were a case of deconditioning, the cardiac measurements would be
worse in the more severely affected compared to the mild, as they have
poorer physical functioning.

What made this study better than the previous one?

Much larger patient cohort. The previous study tested 26 ME/CFS
patients, whereas this current study involved 150 ME/CFS patients.
Improved method of measuring cardiac parameters. The reliability of
the previous study's method (pulse contour analysis) is questionable,
whereas the current study used a validated technique (suprasternal
aortic Doppler echography) (van Geldorp et al., 2011).
The latest study compared results across illness severities. This
revealed that the cardiac abnormalities could not be due to
deconditioning.

What were the two key measures found to be different?

Cardiac output = The volume of blood pumped by the heart per minute.

Stroke Volume = The volume of blood pumped by the left ventricle of
the heart per heartbeat.

Both of these measures usually decrease upon standing. However, they
were found to decrease more in the patients with ME/CFS, compared to
the healthy controls.

Continued…

________________________________

This research review is available for free.

<https://www.meassociation.org.uk/wp-content/uploads/MEA-Review-Abnormal-cardiac-changes-in-MECFS-not-due-to-deconditioning-23.11.18.pdf>

Click to read online or to download.

________________________________

The MEA Ramsay Research Fund Christmas Appeal

We want to invest in more research in 2019 and we need you help to do it.

If you would like to support our Christmas Appeal, then please:

Donate online via our JustGiving page
<https://www.justgiving.com/campaigns/charity/meassociation/ramsayresearchfund>
,
Donate by card over the phone to head office (01280 818964).
Donate by cheque payable to The ME Association (with a note saying
that it is for the Christmas Appeal) to ME Association, 7 Apollo
Office Court, Radclive Road, Gawcott, Buckinghamshire, MK18 4DF.

For more information please visit our Christmas Appeal webpage
<https://www.meassociation.org.uk/xmas-appeal/> . And if you have any
questions get in touch with Helen Hyland or Head Office. Thank you.

* * *

I once led a doctor by the hand through no, you would not become that deconditioned that quickly; it would take months to become so deconditioned that you can't walk two blocks.  

And half a minute later, he was back to insisting that I was "just deconditioned" and needed to exercise my way back to health.

So I walked him through it again, that in a matter of days I went from being able to walk 5 miles a day to barely making it from the bus stop to my desk, and then having to rest for an hour before I could do any work.  Again, he agreed that it would take months to get that out of shape, and again he promptly reverted to telling me that there was nothing physically wrong other than I'd let myself become deconditioned and would be back to normal in a jiffy if I just pushed myself to exercise a little more each day.

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