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Clin Cardiol. 2011 Nov 28. doi: 10.1002/clc.20962. [Epub ahead of print]
Small Heart With Low Cardiac Output for Orthostatic Intolerance in
Patients With Chronic Fatigue Syndrome.
Miwa K, Fujita M.
SourceDepartment of Internal Medicine, Miwa Naika Clinic, Toyama.
info@miwa-naika.com.
Abstract
BACKGROUND: The etiology of chronic fatigue syndrome (CFS) is unknown.
Orthostatic intolerance (OI) is common in CFS patients. Recently,
small heart with low cardiac output has been postulated to be related
to the genesis of both CFS and OI.
HYPOTHESIS: Small heart is associated with OI in patients with CFS.
METHODS: Study CFS patients were divided into groups of 26 (57%)
CFSOI(+) and 20 (43%) CFSOI(-) according to the presence or absence of
OI. In addition, 11 OI patients and 27 age- and sex-matched control
subjects were studied. Left ventricular (LV) dimensions and function
were determined echocardiographically.
RESULTS: The mean values of cardiothoracic ratio, systemic systolic
and diastolic pressures, LV end-diastolic dimension, LV end-systolic
dimension, stroke volume index, cardiac index, and LV mass index were
all significantly smaller in CFSOI(+) patients than in CFSOI(-)
patients and healthy controls, and also in OI patients than in
controls. A smaller LV end-diastolic dimension (<40 mm) was
significantly (P<0.05) more prevalently noted in CFSOI(+) (54%) and OI
(45%) than in CFSOI(-) (5%) and controls (4%). A lower cardiac index
(<2 L/min/mm(2) ) was more prevalent in CFSOI(+) (65%) than in
CFSOI(-) (5%, P<0.01), OI (27%), and controls (11%, P<0.01).
CONCLUSIONS: A small size of LV with low cardiac output was noted in
OI, and its degree was more pronounced in CFSOI(+). A small heart
appears to be related to the genesis of OI and CFS via both cerebral
and systemic hypoperfusion. CFSOI(+) seems to constitute a
well-defined and predominant subgroup of CFS. =A9 2011 Wiley
Periodicals, Inc. The authors have no funding, financial
relationships, or conflicts of interest to disclose.
=A9 2011 Wiley Periodicals, Inc.
PMID:22120591[PubMed - as supplied by publisher]
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