Large & Small Artery Endothelial Dysfunction in CFS Newton et al - heart risk

[Glynis Steele]

http://niceguidelines.files.wordpress.com/2011/12/large-and-small-artery-endothelial-dysfunction.pdf

The end of this article reads "This evidence collectively points to increased cardiovascular risk in ME/CFS patients, which is borne out epidemiologicially by their high mortality due to heart disease".

 

[Enid]

Interesting find - thanks Glynis. It is good to see certain symptoms explained - "can't find any veins" said the nurse trying draw blood at one stage and heart taking off at high speed episodes on other occasions.

 

[voner]

would somebody like to explain what these results say is going on in the veins and arteries of ME/CFS patients? Anybody know what sheer stress is?

Flow?mediated dilatation was significantly lower in the ME/CFS group than in the control group (median [interquartile range]: 5.99 [3.65] versus 9.24 [3.47]%, p<0.001). Post?occlusive reactive hyperaemia in the forearm microcirculation was also significantly lower in ME/CFS patients (area under the response curve: 19.76 [15.46] versus 38.70 [18.14] AU?min, p=0.012).

thanks and events.

 

[Holmsey]

Just a bit of additional info from Dr. Newton regarding the cohort.

Since our original manuscript had to be cut down to fit into a research letter, we had to miss out some of the information about the participants. Here's our original paragraph, which hopefully answers your questions.

The study included 39 patients (mean standard deviation age 5211 years, 18 men) who fulfilled Centers for Disease Control and Prevention criteria for CFS, and who had been assessed by us previously for disease onset, symptom severity and duration of illness. Their mean blood pressure was 12921/8014 mmHg. A control group was also recruited, consisting of 36 healthy volunteers matched for age and gender (mean age
5011 years, 17 men). Their mean blood pressure was 12516/7610 mmHg.

This work was actually funded by the charity ME Research UK not the CSO. Since completing the project, I am no longer involved directly in clinical research so I don't know exactly what the situation is, but the group is certainly continuing to research this area.

 

[Pyrrhus]

Final publication:

Large and small artery endothelial dysfunction in chronic fatigue syndrome (Newton et al., 2012)
David J Newton, Gwen Kennedy, Kenneth K F Chan, Chim C Lang, Jill J F Belch, Faisel Khan
https://www.internationaljournalofcardiology.com/article/S0167-5273(11)01904-8/fulltext

Excerpt:

There is accumulating evidence that myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is associated with cardiovascular symptoms including autonomic dysfunction [ [1] ], impaired blood pressure regulation [ [2] ] and loss of beat-to-beat heart rate control [ [3] ]. A number of recent studies reporting raised levels of oxidative stress [ [4] ], low-grade inflammation [ [5] ] and increased arterial stiffness contribute to a picture of increased cardiovascular risk in ME/CFS.

One potential site of oxidative injury is the vascular endothelium, and such damage would be expected to lead to endothelial cell dysfunction and diminished vasodilator capacity. The primary aim of the current study was to investigate large-vessel endothelial function in ME/CFS using flow-mediated dilatation (FMD), and to assess microvascular endothelial function using post-occlusive reactive hyperaemia, both of which have been shown to be related to cardiovascular risk and outcome [ 6 , 7 ].

This study used two techniques to measure endothelial dysfunction:

• Flow-mediated dilation (FMD)
• Post-occlusive reactive hyperemia (PORH)

There are many different types of endothelial dysfunction in blood vessels, and FMD appears to only measure the ability of arteries (not veins) to dilate in response to nitric oxide (not in response to autonomic nerves).

PORH is a broader measure of endothelial dysfunction, which looks at microvascular tissue and may take into account input from the nervous system, but this broader approach might also make the resultant data harder to interpret.

 

[Booble]

I wonder what the suggestions are to minimize that.

 

[pamojja]

I wonder what the suggestions are to minimize that.

I had a 80% stenosis at my abdominal aorta-bifurcation (PAD) which gave me a 60% walking-disabilty. The official life-style recommendations for that are low-fat, exercising walking to increase blood-flow, and smoking-cessation. Did all of that for almost half a year, but pain-free walking distance decreased even drastically further down to 3-400 meters only.

Pharmaceutically they precribe statins, aspirin and blood-pressure lowering medications. All of which never could reverse a stenosis, But only marginally decrease 5-year mortality. In 1 out of 83 who take statins, in 1 out of 330 who take aspirin, and in 1 out of 125 who take blood-pressure medication only. Surgical stenting in addtion was found to not save even one life after 5 years. All that for secondary prevention, if one never already had an heart-attack, the numbers needed to treat shoot up even more astronomically.

Most these intervention seemed really non-sensical too me, since they didn't reverse anyting. Only a surgical synthetic prosthesis of the aorta down into the legs may could have given relieve from the walking-disabilty. But for me seemed too risky, Because too often they have to be replaced again in major risky surgeries. Something I definitely wanted to avoid during my comming advanced age.


Therefore with nothing further to loose, I followed Linus Pauling's comprehensive supplement recommendations for cardiavascular disease (lacking any trial-data for its efficacy), and Dr. William Davis of the then TrackYourPlaque forum for life-style recommendations (low-carb/high fat).

Which both together increased pain-free walking distance to 2 hours within 3 years again. At which point I suffered a chronic bronchitis for 1 whole year, decreasing it to half-hour again. Employed sea-air and lots of sunshine on a South-Indian beach along with Ayurvedic herbals against to get rid of the bronchitis again. Which later got diagnosed as COPD, asymptomatic since.

Finally after about 7 years of all my efforts my walkiing-disabilty went in complete remission. Remaining PEMs with the 10th year. Affter additionally removing my only root-canal treated tooth (made just before my diagnosis of PAD against my explicit decision not to), getting almost monthly Mg-sulfate IVs against a very insidious Mg-deficiency, and LDN.


So basically I did everything opposite to the standart of care, and experienced remissions. While the 1/2 year following standart of care lifestyle recommendations it became worst, during the whole of these 12 years now.

I wonder what the suggestions are to minimize that.

Therefore everyone has to take responsibilty for deciding between completely contradicting suggestions oneself. I don't give any with my personal experience. Only for myself I believe I could have avoided the severity of my issue, if I wouldn't have been for 30 years a low-fat vegetarian, and engage in sensible supplementation long before my event.

 

[Booble]

Very interesting, thank you.

 

[Rufous McKinney]

Only for myself I believe I could have avoided the severity of my issue, if I wouldn't have been for 30 years a low-fat vegetarian

Decades ago, I followed the extreme diet that was extreme vegan. About three years of this, I was in very very lousy poor physical condition. I don't do well at all on this vegetatian focused diet. and thank good ness I stopped it.

 

[Pyrrhus]

I wonder what the suggestions are to minimize that.

First we have to understand what the research findings actually mean, before we begin to talk about any possible treatments...

I had a 80% stenosis at my abdominal aorta-bifurcation (PAD) which gave me a 60% walking-disabilty. The official life-style recommendations for that are low-fat, exercising walking to increase blood-flow, and smoking-cessation. Did all of that for almost half a year, but pain-free walking distance decreased even drastically further down to 3-400 meters only.

Sorry to hear that!

We should clarify, though, that there are two completely separate phenomena raised by this Letter to the Editor:

1. Arterial stiffness, due to plaque buildup in the linings of the arteries, possibly related to oxidative stress in the linings of the arteries.
2. Endothelial dysfunction, which in this case means the failure of arteries to release Nitric Oxide (NO) when dilation of arteries is needed. (Arteries can release NO when they need to dilate, and this NO is picked up by the muscles surrounding the arteries. These muscles then relax in response to the NO, allowing the arteries to dilate.)

Hope this helps.

 

[Rufous McKinney]

Arterial stiffness, due to plaque buildup in the linings of the arteries, possibly related to oxidative stress in the linings of the arteries.

as a reminder to folks concerned about this symptom.....(yes, thats me).....

these Proteolytic enzymes may be a tool to reduce this arterial plaque.

like: serrapeptase. (also probably nattokinase,)

https://advancedrejuvenation.us/ser...your-joints-body-and-brain-with-serrapeptase/

Go slow- detox effects.

I taste metal when I do serrapeptase (one). I'll then wait days or weeks before taking another, as I hate detox

But I've got to push thru this. Doing a herbal lymph detox now, my swollen nodes went way down (and I crashed for 3 days), neurology.

 

[pamojja]

We should clarify, though, that there are two completely separate phenomena raised by this Letter to the Editor:

1. Arterial stiffness, due to plaque buildup in the linings of the arteries, possibly related to oxidative stress in the linings of the arteries.
2. Endothelial dysfunction, which in this case means the failure of arteries to release Nitric Oxide (NO) when dilation of arteries is needed. (Arteries can release NO when they need to dilate, and this NO is picked up by the muscles surrounding the arteries. These muscles then relax in response to the NO, allowing the arteries to dilate.)

With such serious stenosis as in my case both processes simultaneously and interconnectedly are at work. A couple more for my remission from the walking-disability. I suspect the most important in my case after easing the oxidation and relaxing the arteries was angiogenesis. The endogenous creation of new blood-vessel, or expanding existing, to bypass a stenosis. Which by the way is still there.

However one has to consider the aorta-bifurcation is at least 2cm in diameter, 80% blockage is only a rough estimation from an MRI and ultrasounds. For example my CIMT (carodid intima thickness) decreased from 1.9 mm to 0.9 (below 0.9 would be normal). 1 mm difference in the aorta of course didn't make a visible difference.

 

[Booble]

Decades ago, I followed the extreme diet that was extreme vegan. About three years of this, I was in very very lousy poor physical condition. I don't do well at all on this vegetatian focused diet. and thank good ness I stopped it.

I can related to that. While I never went fully vegan or vegetarian, I felt infinitely better when I added red meat back into my diet.

 

[pamojja]

I could have avoided the severity of my issue, if I wouldn't have been for 30 years a low-fat vegetarian,

I followed the extreme diet that was extreme vegan. About three years of this, I was in very very lousy poor physical condition.

The problem for me was I never felt bad on a low-fat vegetarian diet. On the contrary, made the experience my immune-system could take it up with anything thrown at it (mumps, measels, tuberculosis, malarias, spnondilodisitis, schistosomiasis, ...). Only at about age 40 that illusion collapsed, and I realized too late all those incidences on top of it had ruined my health.

Even I added daily eggs, weekly fish, and loads of healthy natural fats, for beef my taste is still already satisfied once every 2-3 months only. We all have different needs.

 

[kewia]

Besides, every person needs a personalized nutrient regime there is still a common belief that rich-fat diet implies exceeding amounts of fat in human bodies, but that was refuted some time ago.
Nonetheless, this belief is still holding in many heads. There are still many food pyramids out there which didn't incorporate the newly gained knowledge, sadly.

 

[Oliver3]

http://niceguidelines.files.wordpress.com/2011/12/large-and-small-artery-endothelial-dysfunction.pdf

The end of this article reads "This evidence collectively points to increased cardiovascular risk in ME/CFS patients, which is borne out epidemiologicially by their high mortality due to heart disease".

Ah great....were screwed

 

[Oliver3]

With such serious stenosis as in my case both processes simultaneously and interconnectedly are at work. A couple more for my remission from the walking-disability. I suspect the most important in my case after easing the oxidation and relaxing the arteries was angiogenesis. The endogenous creation of new blood-vessel, or expanding existing, to bypass a stenosis. Which by the way is still there.

However one has to consider the aorta-bifurcation is at least 2cm in diameter, 80% blockage is only a rough estimation from an MRI and ultrasounds. For example my CIMT (carodid intima thickness) decreased from 1.9 mm to 0.9 (below 0.9 would be normal). 1 mm difference in the aorta of course didn't make a visible difference.

Could arterial stiffness be a compensatory mechanism for weak connective tissue, rather than plaque. I have no plaquing at all but smthg feels wrong in the vascular system

 

[Oliver3]

I had a 80% stenosis at my abdominal aorta-bifurcation (PAD) which gave me a 60% walking-disabilty. The official life-style recommendations for that are low-fat, exercising walking to increase blood-flow, and smoking-cessation. Did all of that for almost half a year, but pain-free walking distance decreased even drastically further down to 3-400 meters only.

Pharmaceutically they precribe statins, aspirin and blood-pressure lowering medications. All of which never could reverse a stenosis, But only marginally decrease 5-year mortality. In 1 out of 83 who take statins, in 1 out of 330 who take aspirin, and in 1 out of 125 who take blood-pressure medication only. Surgical stenting in addtion was found to not save even one life after 5 years. All that for secondary prevention, if one never already had an heart-attack, the numbers needed to treat shoot up even more astronomically.

Most these intervention seemed really non-sensical too me, since they didn't reverse anyting. Only a surgical synthetic prosthesis of the aorta down into the legs may could have given relieve from the walking-disabilty. But for me seemed too risky, Because too often they have to be replaced again in major risky surgeries. Something I definitely wanted to avoid during my comming advanced age.


Therefore with nothing further to loose, I followed Linus Pauling's comprehensive supplement recommendations for cardiavascular disease (lacking any trial-data for its efficacy), and Dr. William Davis of the then TrackYourPlaque forum for life-style recommendations (low-carb/high fat).

Which both together increased pain-free walking distance to 2 hours within 3 years again. At which point I suffered a chronic bronchitis for 1 whole year, decreasing it to half-hour again. Employed sea-air and lots of sunshine on a South-Indian beach along with Ayurvedic herbals against to get rid of the bronchitis again. Which later got diagnosed as COPD, asymptomatic since.

Finally after about 7 years of all my efforts my walkiing-disabilty went in complete remission. Remaining PEMs with the 10th year. Affter additionally removing my only root-canal treated tooth (made just before my diagnosis of PAD against my explicit decision not to), getting almost monthly Mg-sulfate IVs against a very insidious Mg-deficiency, and LDN.


So basically I did everything opposite to the standart of care, and experienced remissions. While the 1/2 year following standart of care lifestyle recommendations it became worst, during the whole of these 12 years now.



Therefore everyone has to take responsibilty for deciding between completely contradicting suggestions oneself. I don't give any with my personal experience. Only for myself I believe I could have avoided the severity of my issue, if I wouldn't have been for 30 years a low-fat vegetarian, and engage in sensible supplementation long before my event.

Thats amazing...the Linus Paul was just vit c high dosing?

 

[Bobbi007]

I was diagnosed with endothelial dysfunction via a provocative angiogram in 2020. My LAD spasm’d with the introduction of acetylcholine.