Document Detail

Hemodynamics instability score in chronic fatigue syndrome and in non-chronic fatigue syndrome.
MedLine Citation:
PMID:  12528078     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In studying patients with chronic fatigue syndrome (CFS) we developed a method that confers numerical expression to the degree of blood pressure and heart rate lability, ie, the 'hemodynamic instability score' (HIS). The HIS in CFS patients differed significantly from healthy subjects. The present investigation compares the HIS in CFS, non-CFS chronic fatigue and patients with recurrent syncope. METHODS: Patients with CFS (n = 21), non-CFS chronic fatigue (n = 24), syncope of unknown cause (n = 44), and their age and sex-matched healthy controls (n = 21) were evaluated with a standardized head-up tilt test (HUTT). Abnormal reactions (endpoints) on HUTT were classified 'clinical outcomes' (cardioinhibitory or vasodepressor reaction, orthostatic hypotension, postural tachycardia syndrome) and 'HIS endpoint', i.e. HIS >-0.98. RESULTS: The highest incidence of endpoints was noted in patients with CFS (79%), followed by patients with syncope of unknown cause (46%), non-CFS chronic fatigue (35%), and healthy subjects (14%). Presyncope or syncope during tilt occurred in 38% of CFS patients, 21% of patients with non-CFS chronic fatigue, and 43% of patients with recurrent syncope. The average HIS values were: CFS = +2.02 (SD 4.07), non-CFS chronic fatigue = -2.89 (SD 3.64), syncope = -3.2 (SD 3.0), healthy = -2.48 (4.07). The odds ratios for CFS patients to have HIS >-0.98 was 8.8 compared with non-CFS chronic fatigue patients, 14.6 compared with recurrent syncope patients, and 34.8 compared with healthy subjects. CONCLUSION: The cardiovascular reactivity in patients with CFS has certain features in common with the reactivity in patients with recurrent syncope or non-CFS chronic fatigue, such as the frequent occurrence of vasodepressor reaction, cardioinhibitory reaction, and postural tachycardia syndrome. Apart from to these shared responses, the large majority of CFS patients exhibit a particular abnormality which is characterized by HIS values >-0.98. Thus, HIS >-0.98 lends objective criteria to the assessment of CFS.
Jochanan E Naschitz; Edmond Sabo; Shaul Naschitz; Itzhak Rosner; Michael Rozenbaum; Madeline Fields; Hillel Isseroff; Renata Musafia Priselac; Luis Gaitini; Samuel Eldar; Eli Zukerman; Daniel Yeshurun; Fields Madelain; Hillel Isseroff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  32     ISSN:  0049-0172     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-01-15     Completed Date:  2003-04-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  141-8     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
Departments of Internal Medicine A, Rheumatology, Anesthesiology, and Surgery, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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MeSH Terms
Blood Pressure
Endpoint Determination
Fatigue Syndrome, Chronic / complications,  physiopathology*
Hypotension, Orthostatic / physiopathology
Syncope, Vasovagal / etiology,  physiopathology
Tachycardia / physiopathology
Tilt-Table Test*
Comment In:
Semin Arthritis Rheum. 2002 Dec;32(3):137-8   [PMID:  12528076 ]
Erratum In:
Semin Arthritis Rheum. 2003 Apr;32(5):343
Note: Madelain, Fields [corrected to Fields, Madeline]; Hillel, Isseroff [corrected to Isseroff, Hillel]

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