Cardiac problems in ME/CFS
Cardiac problems occur as part of a wide range of signs and symptoms in ME/CFS. These include arrhythmia, bradycardia, chest pain, dysautonomia, dyspnea, heart palpitations, heart rate variability, hypotension, low blood volume, neurally mediated hypotension, orthostatic intolerance, poor circulation, postural orthostatic tachycardia, small heart syndrome, small left ventricle, Short QT interval, reduced cardiac volumes and tachycardia.
- 2018, Cardiovascular characteristics of chronic fatigue syndrome
- 2016, Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging.
Abstract - OBJECTIVE: In chronic fatigue syndrome (CFS), only a few imaging and histopathological studies have previously assessed either cardiac dimensions/function or myocardial tissue, suggesting smaller left ventricular (LV) dimensions, LV wall motion abnormalities and occasionally viral persistence that may lead to cardiomyopathy. The present study with cardiac magnetic resonance (CMR) imaging is the first to use a contrast-enhanced approach to assess cardiac involvement, including tissue characterisation of the LV wall. METHODS:CMR measurements of 12 female CFS patients were compared with data of 36 age-matched, healthy female controls. With cine imaging, LV volumes, ejection fraction (EF), mass, and wall motion abnormalities were assessed. T2-weighted images were analysed for increased signal intensity, reflecting oedema (i. e. inflammation). In addition, the presence of contrast enhancement, reflecting fibrosis (i. e. myocardial damage), was analysed. RESULTS: When comparing CFS patients and healthy controls, LVEF (57.9 ± 4.3 % vs. 63.7 ± 3.7 %; p < 0.01), end-diastolic diameter (44 ± 3.7 mm vs. 49 ± 3.7 mm; p < 0.01), as well as body surface area corrected LV end-diastolic volume (77.5 ± 6.2 ml/m2 vs. 86.0 ± 9.3 ml/m2; p < 0.01), stroke volume (44.9 ± 4.5 ml/m2 vs. 54.9 ± 6.3 ml/m2; p < 0.001), and mass (39.8 ± 6.5 g/m2 vs. 49.6 ± 7.1 g/m2; p = 0.02) were significantly lower in patients. Wall motion abnormalities were observed in four patients and contrast enhancement (fibrosis) in three; none of the controls showed wall motion abnormalities or contrast enhancement. None of the patients or controls showed increased signal intensity on the T2-weighted images. CONCLUSION: In patients with CFS, CMR demonstrated lower LV dimensions and a mildly reduced LV function. The presence of myocardial fibrosis in some CFS patients suggests that CMR assessment of cardiac involvement is warranted as part of the scientific exploration, which may imply serial non-invasive examinations.
- "Heart Abnormalities in Chronic Fatigue Syndrome" By Adrienne Dellwo
- "Cardiac Symptoms and Abnormalities Documented in CFS Patients: (A summary of 4 studies by Lerner et al.)" by the Massachusetts CFIDS/ME & FM Association
- Institute of Medicine (USA); Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (10 February 2015), Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness
- Newton, Julia L.; Finkelmeyer, Andreas; Petrides, George; Frith, James; Hodgson, Tim; Maclachlan, Laura; MacGowan, Guy; Blamire, Andrew M. (2016), "Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study", Open Heart, 3 (1), doi:10.1136/openhrt-2015-000381
- Chronic Fatigue Syndrome Treatment Guide, 2nd Edition, By Erica Verrillo
- Miwa, Kunihisa; Fujita, Masatoshi (2008), "Small Heart Syndrome in Patients with Chronic Fatigue Syndrome", Clinical Cardiology, 31 (7): 328–333, PMID 18636530, doi:10.1002/clc.20227
- Miwa, Kunihisa (Jul 2015), "Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle", Heart and Vessels, 30 (4): 484–489, PMID 24736946, doi:10.1007/s00380-014-0510-y
- Naschitz, J; Fields, M; Isseroff, H; Sharif, D; Sabo, E; Rosner, I (2006), "Shortened QT interval: a distinctive feature of the dysautonomia of chronic fatigue syndrome.", Journal of Electrocardiology, 39 (4): 389-94, PMID 16895768, doi:10.1016/j.jelectrocard.2005.10.014
- Tomas, Cara; Finkelmeyer, Andreas; Hodgson, Tim; MacLachlan, Laura; MacGowan, Guy A; Blamire, Andrew M; Newton, Julia L (2017), "Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study", Open Heart, doi:10.1136/openhrt-2017-000697
- Olimulder, MA; Galjee, MA; Wagenaar, LJ; van Es, J; van der Palen, J; Visser, FC; Vermeulen, RC; von Birgelen, C (2016), "Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging.", Netherlands Heart Journal, PMID 27561279, doi:10.1007/s12471-016-0885-8