Biomarker CFS -Impaired blood pressure variability

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QJM

QJM (2012)

doi: 10.1093/qjmed/hcs085

First published online: June 4, 2012

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Impaired blood pressure variability in

chronic fatigue syndrome - a potential

biomarker

J. Frith1,2, P. Zalewski3, J. J. Klawe3, J.

Pairman1,2, A. Bitner3, M. Tafil-Klawe4

and J. L. Newton1,2

Author Affiliations

From the 1UK NIHR Biomedical Research Centre in

Ageing, Newcastle, UK, 2Institute for Ageing and

Health, Newcastle University, Newcastle, UK and

3Department of Hygiene and Epidemiology and

4Department of Physiology, Ludwik Rydygier

Collegium Medicum in Bydgoszcz, Nicolaus

Copernicus University in Torun, Poland

Address correspondence to Professor J. L. Newton,

Institute for Ageing and Health, Medical School,

Framlington Place, Newcastle-upon-Tyne, NE2

4HH, UK. email: julia.newton@...

Received April 4, 2012.

Revision received April 13, 2012.

Abstract

Introduction:

Autonomic dysfunction is common in chronic

fatigue syndrome (CFS).

This study set out to derive an autonomic biomarker

using a comprehensive assessment of heart rate

and blood pressure variability.

Methods:

Heart rate and non-invasive continuous blood

pressure measurements (task force monitor) at

rest and on standing were performed in CFS

(Fukuda n=68) and matched controls (n=68) to

derive high frequency (HF; parasympathetic) and

low frequency (LF; sympathetic) heart rate

variability (HRV), systolic (SBPV) and diastolic

(DBPV) blood pressure variability.

Variables of significance were combined using

receiver operator curves to explore the diagnostic

utility of parameters particularly at rest.

Results:

At rest, LF-HRV (sympathetic) was significantly

increased in CFS compared to controls, while

parasympathetic markers were significantly

reduced (P=0.006).

Total DBP spectral power was increased

(P=0.0003) across all domains, with a shift

towards sympathetic and away from

parasympathetic SBPV (P=0.05).

On standing, overall SBPV response was

significantly reduced with reductions in both

sympathetic and parasympathetic components of

SBPV (all P<0.0001).

Change in LF-DBP and relative balance of LF/HF

DBP on standing differed between CFS and

controls (P<0.0001).

Using the 85% sensitivity levels, we determined a

threshold for three chosen resting BPV parameters

of LF DBP >3.185, rest HF DBP >0.86, rest total

DBP >7.05.

Achieving all of these differentiated between CFS

and controls with 77% sensitivity and 53%

specificity.

Conclusion:

This study has shown that there are objectively

measured abnormalities of blood pressure

variability in CFS and that these abnormalities have

the potential to be a bedside diagnostic tool.

© The Author 2012. Published by Oxford University

Press on behalf of the Association of Physicians.

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