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Journal: Psychosomatic Medicine 65:889-895 (2003)
Authors: Arnold Peckerman, PhD, John J. LaManca, PhD,
Bushra Qureishi, MD,
Kristina A. Dahl, MD, Roseli Golfetti, PhD, Yoshiharu
Yamamoto, PhD and
Benjamin H. Natelson, MD
Affiliations: From the VA Medical Center, East
Orange, New Jersey (A.P,
B.H.N.); the CFS Cooperative Research Center,
Department of Neurosciences,
University of Medicine and Dentistry of New Jersey,
Newark, New Jersey
(A.P., B.Q., K.A.D., B.H.N.); the Heart Failure
Center, Division of
Circulatory Physiology, New York Presbyterian
Hospital, New York, New York
(J.J.L.); the Exercise Physiology Laboratory, State
University of Campinas,
Săn Paulo, Brazil (R.G.); and the Educational
Physiology Laboratory,
Graduate School of Education, University of Tokyo,
Tokyo, Japan (Y.Y.).
Address reprint requests to: Arnold Peckerman, PhD,
VA Medical Center,
War-Related Illness and Injury Study Center (129),
385 Tremont Ave., East
NLM Citation: PMID: 14508037
OBJECTIVE: Altered cardiovascular responses to
mental an postural stressors have been reported
in chronic fatigue syndrome (CFS). This study
examined whether those findings may involve changes in baroreceptor
reflex functioning.
METHODS: Chronotropic baroreceptor reflex (by
sequential analysis) and cardiovascular stress responses were recorded during
postural (5-minute of active standing) and cognitive (speech task) stress
testing in patients with CFS grouped into cases with severe (N = 21) or
less severe (N = 22)
illness, and in 29 matched control subjects.
RESULTS: Patients with CFS had a greater
decline in baroreceptor reflex sensitivity (BRS) during standing, although only
those with severe CFS were significantly different from the controls. Systolic
blood pressure declined during standing in the control group but was
maintained in the CFS patients. In contrast, the patients with less severe
CFS had blunted increases in blood pressure during the speech task,
which could not, however, be explained by inadequate inhibition of the
baroreceptor reflex, with all groups showing an appropriate reduction in
BRS during the task.
CONCLUSIONS: These results indicate that in
CFS, deficiencies in orthostatic regulation, but not in centrally mediated
stress responses, may involve the baroreceptor reflex. This study also
suggests that classifying patients with CFS on illness severity may
discriminate between patients with abnormalities in peripheral vs. central
mechanisms of cardiovascular stress responses.
Key Words: chronic fatigue syndrome,
baroreceptor reflex, orthostasis, cardiovascular reactivity.
Abbreviations: AD ACL =
Activation-Deactivation Adjective Check List; BRS = baroreceptor reflex sensitivity; CFS = chronic
fatigue syndrome; DBP = diastolic blood pressure; HR = heart rate; MFI =
Multidimensional Fatigue Inventory; PI = pulse interval; SBP = systolic
blood pressure; SF-36 =
Medical Outcomes Study Short Form-36.
© 2003 American Psychosomatic Society
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[Note - baroreceptor:
A sensory nerve ending that is stimulated by changes
in
pressure.Baroreceptors are found in the walls of the
atria of the heart,
vena cava, aortic arch, and carotid sinus. SYN:
pressoreceptor.
"Taber's Cyclopedic Medical Dictionary," Copyright ©
2001 by F. A. Davis
Co., Phil., PA]
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