Impaired cardiovascular response to standing in Chronic Fatigue Syndrome

Kati

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Eur J Clin Invest. 2010 May 20. [Epub ahead of print]
Hollingsworth KG, Jones DE, Taylor R, Blamire AM, Newton JL.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

Link to abstract

Eur J Clin Invest 2010 Abstract Background Impaired skeletal muscle metabolism is recognized in chronic fatigue syndrome (CFS). This study examined the relationship between skeletal and cardiac muscle function and symptoms on standing in CFS using magnetic resonance spectroscopy (MRS) and impedance cardiography. Materials and methods Phosphocreatine (PCr)/adenosine triphosphate (ATP) ratio by cardiac MRS, PCr/ADP and proton efflux by muscle MRS were performed in 12 CFS (Fukuda) and 8 controls. Head up tilt (HUT) and cardiac contractility (left ventricular work index, LVWI) (n = 64 CFS and matched controls) were found. Fatigue impact was accessed by Fatigue Impact Scale and orthostatic symptoms by Orthostatic Grading Scale (OGS). Results Cardiac PCr/ATP correlated with measures of muscle bioenergetic function (half-time PCr recovery [kappa = -0.71, P = 0.005] and half-time ADP recovery [kappa = -0.60, P = 0.02]) suggesting that the muscle and cardiac bioenergetic function correlate in CFS. Four of 12 (33.3%) CFS patients had PCr/ATP values consistent with significant cardiac impairment. Those with impaired cardiac energy metabolism had significantly reduced maximal and initial proton efflux rates (P < 0.05). Cardiac PCr/ATP ratio correlated with myocardial contractility (LVWI) in response to standing (P = 0.03). On HUT, LVWI on standing was significantly higher in CFS (P = 0.05) with symptoms on standing (OGS) occurring in 61/64 (95%) (vs. 25/64 [39%] controls; P < 0.0001). OGS scores were significantly higher in those with abnormal LVWI responses to standing (P = 0.04), with the LVWI on standing correlating with OGS scores (r(2) = 0.1; P = 0.03). HUT was positive in 19 (32%). Conclusions Skeletal muscle and cardiac bioenergetic abnormalities associate in CFS. Cardiac bioenergetic metabolism associates with increase in cardiac contractility on standing. Haemodynamic assessment in CFS is well tolerated and safe with a high diagnostic yield comparable with unexplained syncope.
 
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DysautonomiaXMRV

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Interesting research thanks for posting.

It's such a blow the Medical Research Council (MRC) in the UK refuses to fund Professor Newton's applications for grants, instead they give millions to Wessely and the somatoform school of psychiatry.
 

ramakentesh

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Marvin medows and Julian Stewart have not only reported abnormal autonomic control and they are now publishing research that is demonstrating the etiology.
 

Dolphin

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I'm afraid I'm sometimes get a bit lost when cardiac issues are discussed (stopped studying biology at age 16).

Is any of what she says/found about the heart similar to what Dr. Lerner postulates (I know she doesn't talk about viruses specifically):

http://www.forums.aboutmecfs.org/sh...the-Lerner-Antiviral-Treatment-Trial-Succeeds

http://www.forums.aboutmecfs.org/co...the-Lerner-Antiviral-Treatment-Trial-Succeeds

Link to full paper
http://www.dovepress.com/subset-dir...us-patients-with-c-peer-reviewed-article-VAAT
 

thegodofpleasure

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Interesting research thanks for posting.

It's such a blow the Medical Research Council (MRC) in the UK refuses to fund Professor Newton's applications for grants, instead they give millions to Wessely and the somatoform school of psychiatry.
If you read the "Sources of funding" listed on P7 of the full version of the paper, you will see that the MRC did actually contribute to funding this study - in addition to ME Research UK, Irish ME Trust, John Richardson Research Group and CFS ⁄ME Northern Clinical Network.

Don't get me wrong, I agree that the MRC's scandalous underfunding of biomedical research into ME/CFS deserves to be criticised, but we have a responsibility to properly credit them with having sponsored such research when they have done so.

I think that your post should therefore be corrected.

TGOP
 

Dolphin

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If you read the "Sources of funding" listed on P7 of the full version of the paper, you will see that the MRC did actually contribute to funding this study - in addition to ME Research UK, Irish ME Trust, John Richardson Research Group and CFS ⁄ME Northern Clinical Network.

Don't get me wrong, I agree that the MRC's scandalous underfunding of biomedical research into ME/CFS deserves to be criticised, but we have a responsibility to properly credit them with having sponsored such research when they have done so.

I think that your post should therefore be corrected.

TGOP
I think Julia Newton had some sort of general grant (of 900,000?) from years back (for autonomic research and the like).

My guess is DysautonomiaXMRV is referring to some specific grant application for ME/CFS research by Julia Newton in recent years that they know about.
The MRC haven't funded specific grant applications for ME/CFS studies except various studies e.g. PACE, FINE, epidemiology, etc. led by those of the CBT School of Thought with regard to the illness.
 
D

DysautonomiaXMRV

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I think Julia Newton had some sort of general grant (of 900,000?) from years back (for autonomic research and the like).

My guess is DysautonomiaXMRV is referring to some specific grant application for ME/CFS research by Julia Newton in recent years that they know about.
The MRC haven't funded specific grant applications for ME/CFS studies except various studies e.g. PACE, FINE, epidemiology, etc. led by those of the CBT School of Thought with regard to the illness.
Thank you Dolphin, this is what I am saying as I didn't say this study I said applications are rejected. Even if you wanted to know and applied for a FOIA request the MRC protect their own and you'll never find out who is blocked for funding due to 'privacy reasons'. This is very very clever as the public cannot find out which applicants are rejected for ME/CFS research (on the basis this breaks applicant confidentiality). Crazy huh? A person took the MRC to court to try and find out, but (of course) lost. The actual wording now I've accessed my neural network is:

''Public interest disclosure did not outweigh the duty of confidentiality owed to the applicants''
Source: Mclachlan Vs MRC (2008). Information Tribunal Appeal Number: EA/2008/0059. Information Commissioner's Ref: FS50074593. 1st December, Procession House, London, EC4.
Regarding the MRC's meddling with ME CFS patients, I suggest (if one is able) to please read the following of how ME CFS is converted in MRC research to 'no specific symptoms' and lets include psychiatrically ill people Oxford CFS - criteria.

See here: http://www.meactionuk.org.uk/SIGNS_in_ME.pdf

There is an irony that despite this great cardio work, JN is on the 'fringe' of ME/CFS and not the core of the NHS. The fatigue clinics in the UK (those that were not shut down by funding being removed around 2006-2007) still continue to offer CBT/GE/Pacing. If Julia had been given money for more research into cardiac muscle abnormalities we'd be really getting somewhere. How one person is meant to manage the whole of the UK, I don't know.

The CFS/ME fatigue clinics concentrate on keeping an activity diary, and only if you're lucky do you get to see a doctor instead of an OT (Occupational Therapist). At least Dysautonomia is beginning to be recognised by a few specialists in the NHS, although they never declare they are ME or CFS people at all, because they aren't! They are either general physicians or specialists in associated conditions - in this case, syncope.

Maybe one day the NHS will provided dedicated Dysautonomia clinics and actual ME and CFS doctors who understand and explore biological mechanisms into neuro immune disease rather that toying around with 'sleep hygeine', which to my horror is a clever way to force the ME CFS patient out of bed, in the belief they are being lazy - on advice of the CFS/ME fatigue clinics again. It, of course, ended in relapse and disaster. Never bothered reported them, they'll only kick off another game of hide and seek. (I was told to get out of bed on 2hrs sleep, every day, and never once stop until my sleep is normal).

So yes, more Julia's please and more research into bio-medical causes of severe fatigue and hemodynamic problems that prevent ME CFS patients even being able to walk in a room, never mind walk from the car park to the hospital clinic. MRC is a total joke for 'CFS/ME' everyone knows, see who's on their panel and ohh look, Mr Wessely and the MRC Research Advisory Group on "CFS/ME" is intimately aquainted. And if it isn't him it's another CBT 'fatigue' drone. Have things moved on? Well in the last 7 years 91% of MRC research funding for ME CFS was psychobabble according to ME Research UK.

Link

Too little too late.