Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.
Medicine (Baltimore)
; 98(43): e17600, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31651868
ABSTRACT
BACKGROUND:
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex condition with no reliable diagnostic biomarkers. Studies have shown evidence of autonomic dysfunction in patients with ME/CFS, but results have been equivocal. Heart rate (HR) parameters can reflect changes in autonomic function in healthy individuals; however, this has not been thoroughly evaluated in ME/CFS.METHODS:
A systematic database search for case-control literature was performed. Meta-analysis was performed to determine differences in HR parameters between ME/CFS patients and controls.RESULTS:
Sixty-four articles were included in the systematic review. HR parameters assessed in ME/CFS patients and controls were grouped into ten categories resting HR (RHR), maximal HR (HRmax), HR during submaximal exercise, HR response to head-up tilt testing (HRtilt), resting HR variability (HRVrest), HR variability during head-up tilt testing (HRVtilt), orthostatic HR response (HROR), HR during mental task(s) (HRmentaltask), daily average HR (HRdailyaverage), and HR recovery (HRR) Meta-analysis revealed RHR (MDâ±â95% CIâ=â4.14â±â1.38, Pâ<â.001), HRtilt (SMDâ±â95% CIâ=â0.92â±â0.24, Pâ<â.001), HROR (0.50â±â0.27, Pâ<â.001), and the ratio of low frequency power to high frequency power of HRVrest (0.39â±â0.22, Pâ<â.001) were higher in ME/CFS patients compared to controls, while HRmax (MDâ±â95% CIâ=â-13.81â±â4.15, Pâ<â.001), HR at anaerobic threshold (SMDâ±â95% CIâ=â-0.44â±â0.30, Pâ=â0.005) and the high frequency portion of HRVrest (-0.34â±â0.22, Pâ=â.002) were lower in ME/CFS patients.CONCLUSIONS:
The differences in HR parameters identified by the meta-analysis indicate that ME/CFS patients have altered autonomic cardiac regulation when compared to healthy controls. These alterations in HR parameters may be symptomatic of the condition.
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Base de dados:
MEDLINE
Assunto principal:
Sistema Nervoso Autônomo
/
Síndrome de Fadiga Crônica
/
Encefalomielite
/
Coração
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article