Autonomic function in patients with Chronic Fatigue Syndrome (CFS)

Subtle signs of autonomic dysfunction and orthostatic intolerance
have been reported in patients with chronic fatigue syndrome
(CFS). To assess cardiovascular autonomic function
noninvasively in an unselected group of patients with CFS, we
examined responsiveness to several cardiovascular reflex tests
in 37 CFS patients and 38 healthy control subjects. Blood
pressure and heart rate (HR) were recorded continuously by a
Finapres device before and during forced breathing, standing
up, Valsalva maneuver, and sustained handgrip exercise (HG).

In addition, a mental arithmetic test was carried out and
questionnaires to assess the severity of CFS symptoms were
completed. At rest, there were no significant differences in
blood pressure or in HR between the two groups. The in- and
expiratory difference in HR tended to be lower in CFS patients
(28.4 +/- 10.5 beats) than in healthy controls (32.2 +/- 9.5)
(p = 0.11). The maximal increase in HR during standing up was
not significantly different between the CFS group (37.6 +/-8.9
beats) and the control group (40.2 +/- 8.9 beats). There were
no significant differences between both groups with regard to
the Valsalva ratio, but the systolic and diastolic blood
pressure responses were significantly larger in CFS patients,
despite the fact that many CFS patients were not able to
sustain the Valsalva maneuver. The HR response to MA was
significantly less in the CFS group (22.6 +/- 9.9) than in the
control group (29.5 +/- 16.7) (p < 0.05), suggesting impaired
cardiac sympathetic responsiveness to mental stress. The lower
HR responses could not be explained by the level of
concentration in the CFS group. During HG exercise, the
hemodynamic responses were lower in the CFS group than in the
control group, but this might be attributed to the lower level
of muscle exertion in CFS patients.

There were no significant
differences between CFS patients with and without symptoms of
autonomic dysfunction regarding the hemodynamic responses to
the cardiovascular reflex tests. The findings of the study
suggest that there are no gross alterations in cardiovascular
autonomic function in patients with CFS.

Soetekouw PM, Lenders JW, Bleijenberg G, Thien T, van der Meer JW

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