Exercise Intolerance in Hypermobility: Systemic Vascular Distensibility relates to exercise capacity in connective tissue disease (Singh et al 2021)

[SWAlexander]

A Similar Kind of Exercise Intolerance is Found in Connective Tissue Diseases, ME/CFS and Long COVID

Results
The study found that the blood vessels of people with CTD did not dilate as much as the healthy controls. The CTD patients also displayed an “impaired stroke volume increase”. As their exercise level increased, their heart should have been pumping out ever-larger amounts of blood, but in the CTD patients, the increased blood flows ceased at an earlier timepoint.
That led to lower levels of oxygen extraction in the muscles, resulting in an early entry into the anaerobic threshold (where anaerobic energy production becomes dominant), and lower levels of energy production in the CTD patients.
Except for the reduced “systemic vascular distensibility”, which has not been measured in ME/CFS, Systrom has found the same findings in ME/CFS and long COVID.
more at: https://www.healthrising.org/blog/2...d-chronic-fatigue-connective-tissue-diseases/

 

[Pyrrhus]

Here's the full abstract:

Systemic vascular distensibility relates to exercise capacity in connective tissue disease (Singh et al., 2021)
https://doi.org/10.1093/rheumatology/keaa510

Objective
Exercise intolerance is a common clinical manifestation of [Connective Tissue Disease (CTD)]. Frequently, CTD patients have associated cardio-pulmonary disease, including pulmonary hypertension or heart failure that impairs aerobic exercise capacity (pVO2). The contribution of the systemic micro-vasculature to reduced exercise capacity in CTD patients without cardiopulmonary disease has not been fully described. In this study, we sought to examine the role of systemic vascular distensibility, α in reducing exercise capacity (i.e. pVO2) in CTD patients.

Methods
Systemic and pulmonary vascular distensibility, α (%/mmHg) was determined from multipoint systemic pressure-flow plots during invasive cardiopulmonary exercise testing with pulmonary and radial arterial catheters in place in 42 CTD patients without cardiopulmonary disease and compared with 24 age and gender matched normal controls.

Results
During exercise, systemic vascular distensibility, α was reduced in CTD patients compared with controls (0.20 ± 0.12%/mmHg vs 0.30 ± 0.13%/mmHg, P =0.01). The reduced systemic vascular distensibility α, was associated with impaired stroke volume augmentation. On multivariate analysis, systemic vascular distensibility, α was associated with a decreased exercise capacity (pVO2) and decreased systemic oxygen extraction.

Conclusion
Systemic vascular distensibility, α is associated with impaired systemic oxygen extraction and decreased aerobic capacity in patients with CTD without cardiopulmonary disease.

Related studies by David Systrom:

Exercise intolerance in ME/CFS:
https://forums.phoenixrising.me/thr...patients-with-me-cfs-joseph-et-al-2021.82907/

Exercise intolerance in Long Covid:
https://forums.phoenixrising.me/thr...al-intolerance-what-helps.85130/#post-2381154

 

[Pyrrhus]

From Wikipedia, for what it's worth:

A connective tissue disease (collagenosis) is any disease that has the connective tissues of the body as a target of pathology. Connective tissue is any type of biological tissue with an extensive extracellular matrix that supports, binds together, and protects organs.

These tissues form a framework, or matrix, for the body, and are composed of two major structural protein molecules: collagen and elastin. There are many different types of collagen protein in each of the body's tissues. Elastin has the capability of stretching and returning to its original length—like a spring or rubber band. Elastin is the major component of ligaments (tissues that attach bone to bone) and skin.

In patients with connective tissue disease, it is common for collagen and elastin to become injured by inflammation. [...] Diseases in which inflammation or weakness of collagen tends to occur are also referred to as collagen diseases. [...] Connective tissue diseases can have strong or weak inheritance risks, and can also be caused by environmental factors.

More information on connective tissue diseases can be found in this sub-forum:
https://forums.phoenixrising.me/forums/connective-tissue-disorders-eds-cci.123/

 

[kangaSue]

Hmm, treating exercise pulmonary hypertension with PDE5 inhibitors improves pulmonary vascular distensibility so given the systemic effects that (the PDE5 inhibitor) Viagra has, is a little blue pill all that's needed?
https://journals.sagepub.com/doi/10.1177/2045894018787381

 

[bread.]

I am saying for a long, long, long time that only a slight bodywide structural blood vasculature dysfunction/abnormality could cause symptoms like in mecfs, just by itself.

Nobody researching this disease ever cared.