scholarly journals Validity of 2-Day Cardiopulmonary Exercise Testing in Male Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

2020 ◽  
Vol 10 (01) ◽  
pp. 68-80 ◽  
Author(s):  
C. (Linda) M. C. van Campen ◽  
Peter C. Rowe ◽  
Frans C. Visser
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome ◽  
Male Patients

scholarly journals Deconditioning does not explain orthostatic intolerance in ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome)

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
C. (Linda) M. C. van Campen ◽  
Peter C. Rowe ◽  
Frans C. Visser
Keyword(s):  
Oxygen Consumption ◽  
Chronic Fatigue Syndrome ◽  
Exercise Testing ◽  
Orthostatic Intolerance ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome

Abstract Background Orthostatic intolerance (OI) is a frequent finding in individuals with myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS). Published studies have proposed that deconditioning is an important pathophysiological mechanism in various forms of OI, including postural orthostatic tachycardia syndrome (POTS), however conflicting opinions exist. Deconditioning can be classified objectively using the predicted peak oxygen consumption (VO2) values from cardiopulmonary exercise testing (CPET). Therefore, if deconditioning is an important contributor to OI symptomatology, one would expect a relation between the degree of reduction in peak VO2during CPET and the degree of reduction in CBF during head-up tilt testing (HUT). Methods and results In 22 healthy controls and 199 ME/CFS patients were included. Deconditioning was classified by the CPET response as follows: %peak VO2 ≥ 85% = no deconditioning, %peak VO2 65–85% = mild deconditioning, and %peak VO2 < 65% = severe deconditioning. HC had higher oxygen consumption at the ventilatory threshold and at peak exercise as compared to ME/CFS patients (p ranging between 0.001 and < 0.0001). Although ME/CFS patients had significantly greater CBF reduction than HC (p < 0.0001), there were no differences in CBF reduction among ME/CFS patients with no, mild, or severe deconditioning. We classified the hemodynamic response to HUT into three categories: those with a normal heart rate and blood pressure response, postural orthostatic tachycardia syndrome, or orthostatic hypotension. No difference in the degree of CBF reduction was shown in those three groups. Conclusion This study shows that in ME/CFS patients orthostatic intolerance is not caused by deconditioning as defined on cardiopulmonary exercise testing. An abnormal high decline in cerebral blood flow during orthostatic stress was present in all ME/CFS patients regardless of their %peak VO2 results on cardiopulmonary exercise testing.

scholarly journals Two-Day Cardiopulmonary Exercise Testing in Females with a Severe Grade of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Comparison with Patients with Mild and Moderate Disease

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 192
Author(s):  
C (Linda) M. C. van Campen ◽  
Peter C. Rowe ◽  
Frans C. Visser
Keyword(s):  
Oxygen Consumption ◽  
Chronic Fatigue Syndrome ◽  
Disease Severity ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome ◽  
Severe Grade

Introduction: Effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of symptoms are characteristic features of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The gold standard to measure the degree of physical activity intolerance is cardiopulmonary exercise testing (CPET). Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients, and that a 2-day CPET protocol further discriminates between ME/CFS patients and sedentary controls. Limited information is present on ME/CFS patients with a severe form of the disease. Therefore, the aim of this study was to compare the effects of a 2-day CPET protocol in female ME/CFS patients with a severe grade of the disease to mildly and moderately affected ME/CFS patients. Methods and results: We studied 82 female patients who had undergone a 2-day CPET protocol. Measures of oxygen consumption (VO2), heart rate (HR) and workload both at peak exercise and at the ventilatory threshold (VT) were collected. ME/CFS disease severity was graded according to the International Consensus Criteria. Thirty-one patients were clinically graded as having mild disease, 31 with moderate and 20 with severe disease. Baseline characteristics did not differ between the 3 groups. Within each severity group, all analyzed CPET parameters (peak VO2, VO2 at VT, peak workload and the workload at VT) decreased significantly from day-1 to day-2 (p-Value between 0.003 and <0.0001). The magnitude of the change in CPET parameters from day-1 to day-2 was similar between mild, moderate, and severe groups, except for the difference in peak workload between mild and severe patients (p = 0.019). The peak workload decreases from day-1 to day-2 was largest in the severe ME/CFS group (−19 (11) %). Conclusion: This relatively large 2-day CPET protocol study confirms previous findings of the reduction of various exercise variables in ME/CFS patients on day-2 testing. This is the first study to demonstrate that disease severity negatively influences exercise capacity in female ME/CFS patients. Finally, this study shows that the deterioration in peak workload from day-1 to day-2 is largest in the severe ME/CFS patient group.

scholarly journals Comparing Idiopathic Chronic Fatigue and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Males: Response to Two-Day Cardiopulmonary Exercise Testing Protocol

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 683
Author(s):  
C. (Linda) M. C. van Campen ◽  
Frans C. Visser
Keyword(s):  
Heart Rate ◽  
Oxygen Consumption ◽  
Chronic Fatigue Syndrome ◽  
Exercise Testing ◽  
Ventilatory Threshold ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome

(1) Introduction: Multiple studies have shown that peak oxygen consumption is reduced in the majority of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS )patients, using the gold standard for measuring exercise intolerance: cardiopulmonary exercise testing (CPET). A 2-day CPET protocol has shown different results on day 2 in ME/CFS patients compared to sedentary controls. No comparison is known between ME/CFS and idiopathic chronic fatigue (ICF) for 2-day CPET protocols. We compared ME/CFS patients with patients with chronic fatigue who did not fulfill the ME/CFS criteria in a male population and hypothesized a different pattern of response would be present during the 2nd day CPET. (2) Methods: We compared 25 male patients with ICF who had completed a 2-day CPET protocol to an age-/gender-matched group of 26 male ME/CFS patients. Measures of oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER) were collected at maximal (peak) and ventilatory threshold (VT) intensities. (3) Results: Baseline characteristics for both groups were similar for age, body mass index (BMI), body surface area, (BSA), and disease duration. A significant difference was present in the number of patients with fibromyalgia (seven ME/CFS patients vs. zero ICF patients). Heart rate at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between 0.002 and <0.0001). ME/CFS patients showed a deterioration of performance on CPET2 as reflected by VO2 and workload at peak exercise and ventilatory threshold, whereas ICF patients showed improved performance on CPET2 with no significant change in peak workload. (4) Conclusion: This study confirms that male ME/CFS patients have a reduction in exercise capacity in response to a second-day CPET. These results are similar to published results in male ME/CFS populations. Patients diagnosed with ICF show a different response on day 2, more similar to sedentary and healthy controls.

scholarly journals Discriminative Validity of Metabolic and Workload Measurements for Identifying People With Chronic Fatigue Syndrome

2013 ◽  
Vol 93 (11) ◽  
pp. 1484-1492 ◽  
Author(s):  
Christopher R. Snell ◽  
Staci R. Stevens ◽  
Todd E. Davenport ◽  
J. Mark Van Ness
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Exercise Testing ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Peak Exercise ◽  
Exercise Tests ◽  
Discriminative Validity ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome

BackgroundReduced functional capacity and postexertion fatigue after physical activity are hallmark symptoms of chronic fatigue syndrome (CFS) and may even qualify for biomarker status. That these symptoms are often delayed may explain the equivocal results for clinical cardiopulmonary exercise testing in people with CFS. Test reproducibility in people who are healthy is well documented. Test reproducibility may not be achievable in people with CFS because of delayed symptoms.ObjectiveThe objective of this study was to determine the discriminative validity of objective measurements obtained during cardiopulmonary exercise testing to distinguish participants with CFS from participants who did not have a disability but were sedentary.DesignA prospective cohort study was conducted.MethodsGas exchange data, workloads, and related physiological parameters were compared in 51 participants with CFS and 10 control participants, all women, for 2 maximal exercise tests separated by 24 hours.ResultsMultivariate analysis showed no significant differences between control participants and participants with CFS for test 1. However, for test 2, participants with CFS achieved significantly lower values for oxygen consumption and workload at peak exercise and at the ventilatory or anaerobic threshold. Follow-up classification analysis differentiated between groups with an overall accuracy of 95.1%.LimitationsOnly individuals with CFS who were able to undergo exercise testing were included in this study. Individuals who were unable to meet the criteria for maximal effort during both tests, were unable to complete the 2-day protocol, or displayed overt cardiovascular abnormalities were excluded from the analysis.ConclusionsThe lack of any significant differences between groups for the first exercise test would appear to support a deconditioning hypothesis for CFS symptoms. However, the results from the second test indicated the presence of CFS-related postexertion fatigue. It might be concluded that a single exercise test is insufficient to reliably demonstrate functional impairment in people with CFS. A second test might be necessary to document the atypical recovery response and protracted fatigue possibly unique to CFS, which can severely limit productivity in the home and workplace.

Assessment of Functional Impairment by Cardiopulmonary Exercise Testing in Patients with Chronic Fatigue Syndrome

2001 ◽  
Vol 8 (3-4) ◽  
pp. 103-109 ◽  
Author(s):  
J. Mark Vanness ◽  
Christopher R. Snell ◽  
Dean M. Fredrickson ◽  
David R. Strayer ◽  
Staci R. Stevens
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Exercise Testing ◽  
Functional Impairment ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Fatigue ◽  
Cardiopulmonary Exercise ◽  
Fatigue Syndrome
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