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Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome
Data on the prevalence of orthostatic intolerance (OI) in patients with chronic fatigue syndrome (CFS) are limited and controversial. We tested the hypothesis that a majority of CFS patients exhibit OI during head-up tilt. Hemodynamic and neurohumoral responses to 40 minutes of head-up tilt were stu...
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Published in: | Clinical autonomic research 2002-08, Vol.12 (4), p.273-280 |
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description | Data on the prevalence of orthostatic intolerance (OI) in patients with chronic fatigue syndrome (CFS) are limited and controversial. We tested the hypothesis that a majority of CFS patients exhibit OI during head-up tilt.
Hemodynamic and neurohumoral responses to 40 minutes of head-up tilt were studied in 36 CFS patients and 36 healthy controls. Changes in stroke volume, cardiac output and peripheral vascular resistance were estimated from finger arterial pressure waveform analysis (Modelflow). Blood samples were drawn before and at the end of head-up tilt for measurement of plasma catecholamines.
At baseline, supine heart rate was higher in CFS patients (CFS: 66.4 +/- 8.4 bpm; controls: 57.4 +/- 6.6 bpm; p < 0.001) as was the plasma epinephrine level (CFS: 0.11 +/- 0.07 nmol/l; controls: 0.08 +/- 0.07 nmol/l: p = 0.015). An abnormal blood pressure and/or heart rate response to head-up tilt was seen in 10 (27.8 %) CFS patients (6 presyncope, 2 postural tachycardia, 2 tachycardia and presyncope) and 6 (16.7 %, p = 0.26) controls (5 presyncope, 1 tachycardia, 2 tachycardia and presyncope). Head-up tilt-negative CFS patients showed a larger decrease in stroke volume during tilt (-46.9 +/- 10.6) than head-up tilt-negative controls (-40.3 +/- 13.6 %, p = 0.008). Plasma catecholamine responses to head-up tilt did not differ between these groups.
Head-up tilt evokes postural tachycardia or (pre)syncope in a minority of CFS patients. The observations in head-up tilt-negative CFS patients of a higher heart rate at baseline together with a marked decrease in stroke volume in response to head-up tilt may point to deconditioning. |
doi_str_mv | 10.1007/s10286-002-0014-1 |
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Hemodynamic and neurohumoral responses to 40 minutes of head-up tilt were studied in 36 CFS patients and 36 healthy controls. Changes in stroke volume, cardiac output and peripheral vascular resistance were estimated from finger arterial pressure waveform analysis (Modelflow). Blood samples were drawn before and at the end of head-up tilt for measurement of plasma catecholamines.
At baseline, supine heart rate was higher in CFS patients (CFS: 66.4 +/- 8.4 bpm; controls: 57.4 +/- 6.6 bpm; p < 0.001) as was the plasma epinephrine level (CFS: 0.11 +/- 0.07 nmol/l; controls: 0.08 +/- 0.07 nmol/l: p = 0.015). An abnormal blood pressure and/or heart rate response to head-up tilt was seen in 10 (27.8 %) CFS patients (6 presyncope, 2 postural tachycardia, 2 tachycardia and presyncope) and 6 (16.7 %, p = 0.26) controls (5 presyncope, 1 tachycardia, 2 tachycardia and presyncope). Head-up tilt-negative CFS patients showed a larger decrease in stroke volume during tilt (-46.9 +/- 10.6) than head-up tilt-negative controls (-40.3 +/- 13.6 %, p = 0.008). Plasma catecholamine responses to head-up tilt did not differ between these groups.
Head-up tilt evokes postural tachycardia or (pre)syncope in a minority of CFS patients. The observations in head-up tilt-negative CFS patients of a higher heart rate at baseline together with a marked decrease in stroke volume in response to head-up tilt may point to deconditioning.</description><identifier>ISSN: 0959-9851</identifier><identifier>EISSN: 1619-1560</identifier><identifier>DOI: 10.1007/s10286-002-0014-1</identifier><identifier>PMID: 12357281</identifier><identifier>CODEN: CAURE9</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Adult ; Blood Pressure ; Chronic fatigue syndrome ; Epinephrine - blood ; Fatigue Syndrome, Chronic - physiopathology ; Fatigue Syndrome, Chronic - psychology ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Norepinephrine - blood ; Surveys and Questionnaires ; Tilt-Table Test</subject><ispartof>Clinical autonomic research, 2002-08, Vol.12 (4), p.273-280</ispartof><rights>Copyright Springer-Verlag 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c324t-14537c54ad8059ca8979ae186cca184b583faee980248a565ef0a9f06bd6d0ec3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12357281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Timmers, H J L M</creatorcontrib><creatorcontrib>Wieling, W</creatorcontrib><creatorcontrib>Soetekouw, P M M B</creatorcontrib><creatorcontrib>Bleijenberg, G</creatorcontrib><creatorcontrib>Van Der Meer, J W M</creatorcontrib><creatorcontrib>Lenders, J W M</creatorcontrib><title>Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome</title><title>Clinical autonomic research</title><addtitle>Clin Auton Res</addtitle><description>Data on the prevalence of orthostatic intolerance (OI) in patients with chronic fatigue syndrome (CFS) are limited and controversial. We tested the hypothesis that a majority of CFS patients exhibit OI during head-up tilt.
Hemodynamic and neurohumoral responses to 40 minutes of head-up tilt were studied in 36 CFS patients and 36 healthy controls. Changes in stroke volume, cardiac output and peripheral vascular resistance were estimated from finger arterial pressure waveform analysis (Modelflow). Blood samples were drawn before and at the end of head-up tilt for measurement of plasma catecholamines.
At baseline, supine heart rate was higher in CFS patients (CFS: 66.4 +/- 8.4 bpm; controls: 57.4 +/- 6.6 bpm; p < 0.001) as was the plasma epinephrine level (CFS: 0.11 +/- 0.07 nmol/l; controls: 0.08 +/- 0.07 nmol/l: p = 0.015). An abnormal blood pressure and/or heart rate response to head-up tilt was seen in 10 (27.8 %) CFS patients (6 presyncope, 2 postural tachycardia, 2 tachycardia and presyncope) and 6 (16.7 %, p = 0.26) controls (5 presyncope, 1 tachycardia, 2 tachycardia and presyncope). Head-up tilt-negative CFS patients showed a larger decrease in stroke volume during tilt (-46.9 +/- 10.6) than head-up tilt-negative controls (-40.3 +/- 13.6 %, p = 0.008). Plasma catecholamine responses to head-up tilt did not differ between these groups.
Head-up tilt evokes postural tachycardia or (pre)syncope in a minority of CFS patients. The observations in head-up tilt-negative CFS patients of a higher heart rate at baseline together with a marked decrease in stroke volume in response to head-up tilt may point to deconditioning.</description><subject>Adult</subject><subject>Blood Pressure</subject><subject>Chronic fatigue syndrome</subject><subject>Epinephrine - blood</subject><subject>Fatigue Syndrome, Chronic - physiopathology</subject><subject>Fatigue Syndrome, Chronic - psychology</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Norepinephrine - blood</subject><subject>Surveys and Questionnaires</subject><subject>Tilt-Table Test</subject><issn>0959-9851</issn><issn>1619-1560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNpdkE9LxDAQxYMouq5-AC8SPHirZpomTY4i_gPBi55jNp26lTapSYvstzeyC4KHYWB4783jR8gZsCtgrL5OwEolC8bKPFAVsEcWIEEXICTbJwumhS60EnBEjlP6zBqhOBySIyi5qEsFC_L-iENoNt4OnaPWN9TjHMN6HkK0PY2YxuATJjoFukbbFPNIp66faOfpaKcO_ZTodzetqVvH4HNGm68fM9K08U0MA56Qg9b2CU93e0ne7u9ebx-L55eHp9ub58LxspoKqASvnahso5jQzipda4ugpHMWVLXKxVuLqBUrK2WFFNgyq1smV41sGDq-JJfb3DGGrxnTZIYuOex76zHMydQlcF0qnoUX_4SfYY4-dzOgJWdS5F9LAluRiyGliK0ZYzfYuDHAzC97s2VvMnvzy95A9pzvgufVgM2fYweb_wBkr4AX</recordid><startdate>20020801</startdate><enddate>20020801</enddate><creator>Timmers, H J L M</creator><creator>Wieling, W</creator><creator>Soetekouw, P M M B</creator><creator>Bleijenberg, G</creator><creator>Van Der Meer, J W M</creator><creator>Lenders, J W M</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20020801</creationdate><title>Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome</title><author>Timmers, H J L M ; Wieling, W ; Soetekouw, P M M B ; Bleijenberg, G ; Van Der Meer, J W M ; Lenders, J W M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-14537c54ad8059ca8979ae186cca184b583faee980248a565ef0a9f06bd6d0ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Blood Pressure</topic><topic>Chronic fatigue syndrome</topic><topic>Epinephrine - blood</topic><topic>Fatigue Syndrome, Chronic - physiopathology</topic><topic>Fatigue Syndrome, Chronic - psychology</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Norepinephrine - blood</topic><topic>Surveys and Questionnaires</topic><topic>Tilt-Table Test</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Timmers, H J L M</creatorcontrib><creatorcontrib>Wieling, W</creatorcontrib><creatorcontrib>Soetekouw, P M M B</creatorcontrib><creatorcontrib>Bleijenberg, G</creatorcontrib><creatorcontrib>Van Der Meer, J W M</creatorcontrib><creatorcontrib>Lenders, J W M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical autonomic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Timmers, H J L M</au><au>Wieling, W</au><au>Soetekouw, P M M B</au><au>Bleijenberg, G</au><au>Van Der Meer, J W M</au><au>Lenders, J W M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome</atitle><jtitle>Clinical autonomic research</jtitle><addtitle>Clin Auton Res</addtitle><date>2002-08-01</date><risdate>2002</risdate><volume>12</volume><issue>4</issue><spage>273</spage><epage>280</epage><pages>273-280</pages><issn>0959-9851</issn><eissn>1619-1560</eissn><coden>CAURE9</coden><abstract>Data on the prevalence of orthostatic intolerance (OI) in patients with chronic fatigue syndrome (CFS) are limited and controversial. We tested the hypothesis that a majority of CFS patients exhibit OI during head-up tilt.
Hemodynamic and neurohumoral responses to 40 minutes of head-up tilt were studied in 36 CFS patients and 36 healthy controls. Changes in stroke volume, cardiac output and peripheral vascular resistance were estimated from finger arterial pressure waveform analysis (Modelflow). Blood samples were drawn before and at the end of head-up tilt for measurement of plasma catecholamines.
At baseline, supine heart rate was higher in CFS patients (CFS: 66.4 +/- 8.4 bpm; controls: 57.4 +/- 6.6 bpm; p < 0.001) as was the plasma epinephrine level (CFS: 0.11 +/- 0.07 nmol/l; controls: 0.08 +/- 0.07 nmol/l: p = 0.015). An abnormal blood pressure and/or heart rate response to head-up tilt was seen in 10 (27.8 %) CFS patients (6 presyncope, 2 postural tachycardia, 2 tachycardia and presyncope) and 6 (16.7 %, p = 0.26) controls (5 presyncope, 1 tachycardia, 2 tachycardia and presyncope). Head-up tilt-negative CFS patients showed a larger decrease in stroke volume during tilt (-46.9 +/- 10.6) than head-up tilt-negative controls (-40.3 +/- 13.6 %, p = 0.008). Plasma catecholamine responses to head-up tilt did not differ between these groups.
Head-up tilt evokes postural tachycardia or (pre)syncope in a minority of CFS patients. The observations in head-up tilt-negative CFS patients of a higher heart rate at baseline together with a marked decrease in stroke volume in response to head-up tilt may point to deconditioning.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>12357281</pmid><doi>10.1007/s10286-002-0014-1</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Blood Pressure Chronic fatigue syndrome Epinephrine - blood Fatigue Syndrome, Chronic - physiopathology Fatigue Syndrome, Chronic - psychology Female Heart Rate Humans Male Middle Aged Norepinephrine - blood Surveys and Questionnaires Tilt-Table Test |
title | Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome |
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