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Chronic Neuroimmune Diseases
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Last updated January 1, 2014

Measure Aids CFS Assessment

A DGReview of Hemodynamics instability score in CFS and non-CFS

©2003 Anne MacLennan,

A particular and quantifiable abnormality in the cardiovascular reactivity of most patients with chronic fatigue syndrome provides an new objective tool for assessing this disorder, suggest researchers in Israel.

Using a method they developed of giving numerical expression to degree of blood pressure and heart rate lability, the investigators had previously found this 'haemodynamic instability score' (HIS) in CFS patients differs significantly from that in healthy subjects.

In the current investigation, they found the large majority of CFS patients exhibit an abnormality which is characterised by HIS values >-0.98. Thus, HIS >-0.98 lends objective criteria to the assessment of CFS, report Dr J E Naschitz and colleagues from the Bnai Zion Medical Center and the Technion-Israel Institute of Technology, Haifa, Israel.

This study compared the HIS in CFS, non-CFS chronic fatigue and patients with recurrent syncope.

Twenty patients with CFS, 24 with non-CFS chronic fatigue, 44 with syncope of unknown cause and 21 age and sex-matched healthy controls were all evaluated with a standardised head-up tilt test (HUTT).

Abnormal reactions (endpoints) on HUTT were classified 'clinical outcomes' (cardioinhibitory or vasodepressor reaction, orthostatic hypotension, postural tachycardia syndrome) and 'HIS endpoint', ie HIS >-0.98.

Highest incidence of endpoints was noted in patients with CFS (79%), followed by patients with syncope of unknown cause (46%), non-CFS chronic fatigue (35%) and healthy controls (14%).

Presyncope or syncope during tilt occurred in 38% of CFS patients, 21% of non-CFS chronic fatigue patients and 43% of those with recurrent syncope.

Average HIS values were: CFS = +2.02 (SD 4.07), non-CFS chronic fatigue = -2.89 (SD 3.64), syncope = -3.2 (SD 3.0) and healthy = -2.48 (4.07).

Odds ratios for CFS patients to have HIS >-0.98 was 8.8 compared with non-CFS chronic fatigue patients, 14.6 compared with recurrent syncope patients and 34.8 compared with healthy controls.

The investigators point out the cardiovascular reactivity in patients with CFS has certain features in common with the reactivity in patients with recurrent syncope or non-CFS chronic fatigue, such as the frequent occurrence of vasodepressor reaction, cardioinhibitory reaction, and postural tachycardia syndrome.

However, apart from these shared responses, most patients with CFS exhibit this particular abnormality, which is characterised by HIS values >-0.98, lending objective criteria to CFS assessment, these authors conclude.

Semin Arthritis Rheum 2002 Dec;32(3):141-8. "Hemodynamics instability score in chronic fatigue syndrome and in non-chronic fatigue syndrome."




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