Cerebral blood flow remains reduced after tilt testing in myalgic encephalomyelitis/chronic fatigue syndrome patients
| Autor: | C. (Linda) M. C. van Campen, Peter C. Rowe, Frans C. Visser |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
ICC International Consensus Criteria Supine position Tilt table testing ME/CFS Myalgic encephalomyelitis/chronic fatigue syndrome Normal heart rate and blood pressure response Extracranial Doppler echography Orthostatic intolerance Hemodynamics Neurosciences. Biological psychiatry. Neuropsychiatry Orthostatic vital signs Postural Orthostatic Tachycardia Syndrome VTI Time velocity integral Hypocapnia Recovery Physiology (medical) Internal medicine HR Heart rate Medicine NormHRBP normal heart rate and blood pressure response business.industry CI Cardiac Index Cardiac Index BSA Body Surface Area DBP Diastolic Blood pressure dOH delayed orthostatic hypotension Cerebral blood flow medicine.disease CBF Cerebral blood flow PET end-tidal pressure Blood pressure Neurology SBP Systolic Blood pressure Cardiology POTS Postural orthostatic tachycardia syndrome Neurology (clinical) BMI Body Mass Index business ME/CFS Post exertional malaise Research Paper RC321-571 |
| Zdroj: | Clinical Neurophysiology Practice, Vol 6, Iss, Pp 245-255 (2021) Clinical Neurophysiology Practice |
| Popis: | Highlights • Cerebral blood flow in ME/CFS patients remains abnormal 5 min post-tilt test. • Post cerebral blood flow abnormalities do not depend on hemodynamic results and on end-tidal carbon dioxide pressures during the tilt-test. • Post cerebral blood flow abnormalities are most severe in more severely diseased ME/CFS patients. Objective Orthostatic symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may be caused by an abnormal reduction in cerebral blood flow. An abnormal cerebral blood flow reduction was shown in previous studies, without information on the recovery pace of cerebral blood flow. This study examined the prevalence and risk factors for delayed recovery of cerebral blood flow in ME/CFS patients. Methods 60 ME/CFS adults were studied: 30 patients had a normal heart rate and blood pressure response during the tilt test, 4 developed delayed orthostatic hypotension, and 26 developed postural orthostatic tachycardia syndrome (POTS) during the tilt. Cerebral blood flow measurements, using extracranial Doppler, were made in the supine position pre-tilt, at end-tilt, and in the supine position at 5 min post-tilt. Also, cardiac index measurements were performed, using suprasternal Doppler imaging, as well as end-tidal PCO2 measurements. The change in cerebral blood flow from supine to end-tilt was expressed as a percent reduction with mean and (SD). Disease severity was scored as mild (approximately 50% reduction in activity), moderate (mostly housebound), or severe (mostly bedbound). Results End-tilt cerebral blood flow reduction was −29 (6)%, improving to −16 (7)% at post-tilt. No differences in either end-tilt or post-tilt measurements were found when patients with a normal heart rate and blood pressure were compared to those with POTS, or between patients with normocapnia (end-tidal PCO2 ≥ 30 mmHg) versus hypocapnia (end-tidal PCO2 |
| Databáze: | OpenAIRE |
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