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Cerebral and Systemic Hemodynamics Changes During Upright Tilt in Chronic Fatigue Syndrome
Author(s) -
Razumovsky Alexander Y.,
DeBusk Karen,
Calkins Hugh,
Snader Sally,
Lucas Katherine E.,
Vyas Pranav,
Hanley Daniel F.,
Rowe Peter C.
Publication year - 2003
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2003.tb00158.x
Subject(s) - medicine , supine position , hemodynamics , heart rate , transcranial doppler , blood pressure , chronic fatigue syndrome , postural orthostatic tachycardia syndrome , cerebral blood flow , anesthesia , cardiology , tilt table test , orthostatic vital signs
Background and Purpose . During head‐up tilt (HUT), patients with chronic fatigue syndrome (CFS) have higher rates of neurally mediated hypotension (NMH) and postural tachycardia syndrome (POTS) than healthy controls. The authors studied whether patients with CFS were also more likely to have abnormal cerebral blood flow velocity (CBFV) compared with controls in response to orthostatic stress. Methods . Transcranial Doppler monitoring of middle cerebral artery (MCA) CBFV was performed during 3‐stage HUT prospectively in 26 patients with CFS and 23 healthy controls. At the same time, continuous monitoring of arterial blood pressure (BP), heart rate (HR), end‐tidal CO 2 (ET‐CO 2 ) were performed. Results are reported as mean ± SD. Results . NMH developed in 21 patients with CFS and in 14 controls (P = .22). POTS was present in 9 CFS patients and 7 controls (P = .76). Supine HR was higher in CFS patients, but all other hemodynamics and CBFV measures were similar at baseline. The median time to hypotension did not differ, but the median time to onset of orthostatic symptoms was shorter in those with CFS (P < .001). The CBFV did not differ between groups in the supine posture, at 1 or 5 minutes after upright tilt, at 5 or 1 minute before the end of the test, or at termination of the test. Mean CBFV fell at termination of tilt testing in those with CFS and controls. ET‐CO 2 was lower at termination of the test in those with CFS versus controls (P = .002). Conclusions . The results of this study are not consistent with the hypothesis that patients with CFS have a distinctive pattern of MCA CBFV changes in response to orthostatic stress.