Hemodynamic instability in chronic fatigue syndrome: Indices and diagnostic significance

Naschitz, Jochanan E.; Sabo, Edmond; Naschitz, Shaul; Shaviv, Naomi; Rosner, Itzhak; Rozenbaum, Michael; Gaitini, Luis; Ahdoot, Allen; Ahdoot, Michael; Priselac, Renata Musafia; Eldar, Samuel; Zukerman, Eli; Yeshurun, Daniel

doi:10.1053/sarh.2001.27738

Cited by 26 publications

(21 citation statements)

References 31 publications

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“…Similar to the classical outcomes of the HUTT, abnormalities of HR variability in CFS are not specific for this disorder and have little diagnostic relevance. A third method, recently proposed for the study of the cardiovascular reactivity of CFS patients [11,12] involves computing BP-and HR-changes during the course of a HUTT, followed by processing the data by image analysis methods. Finally, the data receive numerical expression as the 'hemodynamic instability score' (HIS).…”

Section: Introductionmentioning

confidence: 99%

Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome

Naschitz¹,

Sabo²,

Naschitz³

et al. 2002

Clinical Autonomic Research

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This study aimed to develop a method to distinguish between the cardiovascular reactivity in chronic fatigue syndrome (CFS) and other patient populations. Patients with CFS (n = 23), familial Mediterranean fever (n = 15), psoriatic arthritis (n = 10), generalized anxiety disorder (n = 12), neurally mediated syncope (n = 20), and healthy subjects (n = 20) were evaluated with a shortened head-up tilt test (HUTT). A 10-minute supine phase of the HUTT was followed by recording 600 cardiac cycles on tilt, i. e., 5 to 10 minutes. Beat-to-beat heart rate (HR) and pulse transit time (PTT) were acquisitioned. Data were processed by recurrence plot and fractal analysis. Fifty-two variables were calculated in each subject. On multivariate analysis, the best predictors of CFS were HR-tilt-R/L, PTT-tilt-R/L, HR-supine-DET, PTT-tilt-WAVE, and HR-tilt-SD. Based on these predictors, the 'Fractal & Recurrence Analysis-based Score' (FRAS) was calculated: FRAS = 76.2 + 0.04*HR-supine-DET - 12.9*HR-tilt-R/L - 0.31*HR-tilt-SD - 19.27*PTT-tilt-R/L - 9.42* PTT-tilt-WAVE. The best cut-off differentiating CFS from the control population was FRAS = + 0.22. FRAS > + 0.22 was associated with CFS (sensitivity 70 % and specificity 88 %). The cardiovascular reactivity received mathematical expression with the aid of the FRAS. The shortened HUTT was well tolerated. The FRAS provides objective criteria which could become valuable in the assessment of CFS.

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Section: Introductionmentioning

confidence: 99%

Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome

Naschitz¹,

Sabo²,

Naschitz³

et al. 2002

Clinical Autonomic Research

Self Cite

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“…The HIS also discerned the particular reactivity of CFS patients from the cardiovascular reactivities of other patient groups, which may confound the diagnosis of CFS, such as patients with fibromyalgia, non-CFS fatigue, and neurogenic syncope. [28][29][30] The HIS identified a distinctive cardiovascular reactivity in patients with essential hypertension. 7 Thus, the correlation of results obtained by both the FRAS and the HIS methods supports the authenticity of reactivity phenotypes.…”

Section: Distinct Cardiovascular Reactivity Patternsmentioning

confidence: 99%

“…In theses studies, which comprised 70 patients with CFS, 73 patients with non-CFS chronic fatigue, and 41 patients with fibromyalgia, the sensitivity of the HIS for the diagnosis of CFS was 91.4% and the overall specificity was 85.1%. [28][29][30] The high sensitivity and specificity of the HIS for CFS improves on the moderate sensitivity and poor specificity of classical autonomic testing for CFS. [31][32][33] Based on these data, it appears that the HIS can reinforce the clinician's diagnosis by providing objective criteria to the assessment of CFS, which, until now, could only be subjectively inferred.…”

Section: Perspectivesmentioning

confidence: 99%

Assessment of cardiovascular reactivity by fractal and recurrence quantification analysis of heart rate and pulse transit time

et al. 2003

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“…It is very unlikely that all patients meeting specific diagnostic criteria will show abnormal results for all specific objective tests, e.g. repeated exercise tests [41,42], cognitive tests [43,44], tilt table tests [45,46], muscle power (endurance) tests [47,48], but it is essential to establish physiological and neurocognitive abnormalities in the individual patients impartially, both in clinical practice as in research studies.…”

Section: Discussionmentioning

confidence: 99%

“…repeated exercise tests [41,42], cognitive tests [43,44], tilt table tests [45,46], muscle power (endurance) tests [47,48], for diagnosing patients [49] and determining the effect of interventions [50], to find correlations between symptoms/subjective measures and objective test outcomes, and to define symptomatic subgroups of the ME and CFS patient population [51].…”

Section: A New Direction: Back To the Futurementioning

confidence: 99%

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

Twisk¹

2017

J Med Diagn Meth

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Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) are subject to controversy. Although ME and CFS are often considered to be to be synonymous, the case criteria for ME and CFS define two distinct diseases with partial overlap. ME, recognized as a new clinical entity in the 1950's, is characterized by distinctive muscular, neurological and autonomic symptoms. In contrast the core feature of CFS, introduced in 1988 and redefined in 1994, is chronic fatigue. Some researchers consider CFS to be equivalent to (incapacitating) chronic fatigue (CF). After the introduction of CFS, other criteria for ME, ME/CFS, CFS and CF were introduced and used in research studies, creating obfuscation and controversy. The use of various diagnostic criteria has hampered effective research into ME and CFS.Next to the various diagnostic criteria, the assessment of symptoms is almost always based on questionnaires and subjective measures, e.g. physical functioning. Due to their nature subjective measures are incomparable over time and between patients. Moreover subjective measures introduce a significant risk of bias, for example due to researcher allegiance, the Hawthorne effect, and buy-in effects. Despite the fact that ME and CFS (subtypes) lack a clear etiological explanation (yet), the symptoms can and should be assessed by objective test measures, since subjective measures are ambiguous, incomparable and introduce the risk of bias. Objective test measures can also confirm the seriousness of both ME and CFS.To resolve the diagnostic issues in research studies and clinical practice, a clear distinction between ME and CFS (not ME), based on the original criteria, is crucial.Although the use of objective test methods is more expensive and time-consuming and severe cases cannot be subjected to these tests, considering the (scientific) confusion originating from the use of subjective measures it is essential to assess the symptoms of patients objectively both in clinical practice and research settings.

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Hemodynamic instability in chronic fatigue syndrome: Indices and diagnostic significance

Cited by 26 publications

References 31 publications

Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome

Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome

Assessment of cardiovascular reactivity by fractal and recurrence quantification analysis of heart rate and pulse transit time

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

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