Dr. Unger doesn't mention using resting heart rate tests in her “Auugust 30” response. She writes, “Our primary objective is to measure the exercise capacity in as many of the enrolled patients as possible using a standardized protocol, and to monitor the post-exertional response for 48 hours with online cognitive testing and visual analogue scales of fatigue, pain, and symptoms.”
That's a shame. It was at the most recent CFSAC meeting that they were discussing CPET testing, and she was urged to get in touch with Dr Snell about two-day CPET testing, and to test for resting heart rates. She made some notes at the time, and looked like she might be listening. Well, it seems that she did contact Dr Snell, but hasn't yet incorporated two-day CPET testing. With regards to monitoring post-exertion resting heart rate, she also seemed receptive but didn't commit to it. So I was wrong, again, to say that she
is including post-exertion resting heart rate, because I don't have any evidence for it.
I guess I was hoping that it was a commitment, and got over-excited that she would be including these tests. I get the feeling that the study is a work in progress for Unger, and she seems receptive to a certain extent, but extremely slow to make changes. Perhaps well targeted correspondence might encourage her to include tests for these biomarkers.
In this CFSAC video (
0.43.50), Beth Unger states, in relation to exercise tests:
"We are going to be doing cognitive testing afterwards, to show that change, and the suggestion of looking at resting heart rate, we can easily incorporate that into that post monitoring as well."
Perhaps I've been over-enthusiastic about the thought of the CDC carrying out a proper study at long last.
When Dr. Snell speaks here of "failure to reproduce," he's speaking of the patients' failure to reproduce on day two the CPET results that they achieved on day one. He isn't referring to other researchers' failure to replicate his research. In fact, he challenges other researchers to find out why patients can't reproduce their day one results. He suggests "lots of reasons" for his findings and lists on his accompanying slide (177) inflammatory cytokine elevation (Klimas et al., 2007), neuroendocrine dysfunction, cardiovascular abnormalities and mitochondrial abnormalities (Whistler et al., 2006, Wong et al., 1992).
Ah, now I understand. Thanks for that, Ember. I totally misinterpreted it, didn't I. I just couldn't work out what he meant when I looked at it again yesterday.
Apologies again for my misinformation, and thanks for correcting me.
However, I still think that Dr Snell has not replicated his own research. I think his earlier study found useful differences in the VO2 max test, but VO2 max did not provide useful results in his latest study, unless I've misinterpreted it. I might have got this wrong, so I'm happy to be corrected, if anyone can interpret his latest paper. But, in any case, his latest results definitely suggest a great deal of potential in a two-day CPET test.
These are the Snell exercise studies that I can find on Google:
2005,
2007,
2013.