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Sympathetic predominance of cardiovascular regulation during mild orthostatic stress in adolescents with chronic fatigue [syndrome]

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By VB Wyller, et al. • www.ProHealth.com • June 30, 2007


[Note: The sympathetic part of the autonomic nervous system is associated with slowing heart rate, relaxing blood vessels, lowering blood pressure; the parasympathetic part with accelerating, constricting, raising. The more vertical the body, the more stress on the cardiovascular system to supply blood/oxygen to the brain.] Journal: Clinical Physiology and Functional Imaging. 2007 Jul;27(4): pp 231-8

Authors and affiliation: Wyller VB, Saul JP, Amlie JP, Thaulow E. Department of Pediatrics, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, and Department of Pysiology, Unievrsity of Oslo, Oslo, Norway.

PMID: 17564672

Haemodynamic abnormalities have been documented in the Chronic Fatigue Syndrome (CFS), indicating functional disturbances of the autonomic nervous system responsible for cardiovascular control. This study was designed to explore the pathophysiology in adolescent CFS patients by analyzing RR-interval (RRI) variability and diastolic blood pressure (DBP) variability during mild orthostatic stress, using an algorithm which accounts for non-stationary biosignals.

A total of 27 adolescents with CFS and 33 healthy control subjects having equal age- and sex distribution underwent 15 min of 20 degrees head-up tilt (HUT). The spectral power densities of RRI and DBP were computed in the low-frequency (LF) band (0.04-0.15 Hz) and the high-frequency (HF) band (0.15-0.4 Hz) using an adaptive autoregressive algorithm to obtain a time-varying spectrum. RMSSD, a time domain index of RRI variability, was also computed.

At rest, all indices of variability were similar in the two groups.

During tilt, CFS patients had a larger increase in the LF/HF ratio (PCFS patients also had trends towards a larger decrease in absolute high-frequency power of RR-interval and a larger increase in normalized low-frequency power of diastolic blood pressure. These findings suggest that adolescents with CFS have sympathetic predominance of cardiovascular regulation during very mild orthostatic stress.

Possible underlying mechanisms are moderate hypovolemia [decreased blood volume], abnormalities of reflex control or physical de-conditioning.





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