{"id":27687,"date":"2020-08-24T10:56:49","date_gmt":"2020-08-24T10:56:49","guid":{"rendered":"https:\/\/wames.org.uk\/cms-english\/?p=27687"},"modified":"2020-08-26T21:57:18","modified_gmt":"2020-08-26T21:57:18","slug":"hemodynamics-during-the-10-minute-nasa-lean-test-evidence-of-circulatory-decompensation-in-a-subset-of-me-cfs-patients","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/hemodynamics-during-the-10-minute-nasa-lean-test-evidence-of-circulatory-decompensation-in-a-subset-of-me-cfs-patients\/","title":{"rendered":"Hemodynamics during the 10-minute NASA Lean Test: evidence of circulatory decompensation in a subset of ME\/CFS patients"},"content":{"rendered":"

Hemodynamics during the 10-minute NASA Lean Test: evidence of circulatory decompensation in a subset of ME\/CFS patients<\/a> by Jihyun Lee, Suzanne D Vernon, Patricia Jeys, Weam Ali, Andrea Campos, Derya Unutmaz, Brayden Yellman, Lucinda Bateman in<\/span> J Transl Med.<\/em> 2020 Aug 15;18(1):314 [doi: 10.1186\/s12967-020-02481-y]<\/h3>\n

 <\/p>\n

Research abstract:<\/strong><\/h3>\n

Background: <\/strong><\/p>\n

\"\"<\/p>\n

Lightheadedness, fatigue, weakness, heart palpitations, cognitive dysfunction, muscle pain, and exercise intolerance are some of the symptoms of orthostatic intolerance<\/a> (OI). There is substantial comorbidity of OI in ME\/CFS (Myalgic Encephalomyelitis\/ Chronic Fatigue Syndrome). The 10-minute NASA Lean Test<\/a> (NLT) is a simple, point-of-care method that can aid ME\/CFS diagnosis and guide management and treatment of OI. The objective of this study was to understand the hemodynamic changes that occur in ME\/CFS patients during the 10-minute NLT.<\/p>\n

Methods: <\/strong><\/p>\n

A total of 150 ME\/CFS patients and 75 age, gender and race matched healthy controls (HCs) were enrolled. We recruited 75 ME\/CFS patients who had been sick for less than 4 years (< 4 ME\/CFS) and 75 ME\/CFS patients sick for more than 10 years (> 10 ME\/CFS). The 10-minute NLT involves measurement of blood pressure and heart rate while resting supine and every minute for 10 min while standing with shoulder-blades on the wall for a relaxed stance. Spontaneously reported symptoms are recorded during the test. ANOVA and regression analysis were used to test for differences and relationships in hemodynamics, symptoms and upright activity between groups.<\/p>\n

Results: <\/strong><\/p>\n

At least 5 min of the 10-minute NLT were required to detect hemodynamic changes. The < 4 ME\/CFS group had significantly higher heart rate and abnormally narrowed pulse pressure compared to > 10 ME\/CFS and HCs. The < 4 ME\/CFS group experienced significantly more OI symptoms compared to > 10 ME\/CFS and HCs. The circulatory decompensation observed in the < 4 ME\/CFS group was not related to age or medication use.<\/p>\n

Conclusions: <\/strong><\/p>\n

Circulatory decompensation<\/a> characterized by increased heart rate and abnormally narrow pulse pressure was identified in a subgroup of ME\/CFS patients who have been sick for < 4 years. This suggests inadequate ventricular filling<\/a> from low venous pressure. The 10-minute NLT can be used to diagnose and treat the circulatory decompensation in this newly recognized subgroup of ME\/CFS patients.<\/p>\n

The > 10 ME\/CFS group had less pronounced hemodynamic<\/a> changes during the NLT possibly from adaptation and compensation that occurs over time. The 10-minute NLT is a simple and clinically useful point-of-care method that can be used for early diagnosis of ME\/CFS and help guide OI treatment.<\/p>\n

 <\/p>\n

Excerpt<\/strong><\/p>\n

While it isn\u2019t entirely clear why the\u2009>\u200910 ME\/CFS group appear to tolerate the orthostatic stress better than\u2009<\u20094 ME\/CFS in terms of a dramatic drop in pulse pressure, that does not prove they aren\u2019t experiencing a drop in cerebral perfusion. It is possible that after many years of ME\/CFS illness there is gradual adaptation of the circulatory stress response to upright posture. That may also explain why the\u2009>\u200910 ME\/CFS had the highest rise in SBP during the 10-minute NLT. There is also an age difference between the\u2009<\u20094 and\u2009>\u200910 ME\/CFS groups of about 5\u20136\u00a0years which might also explain the higher SBP response in the\u2009>\u200910 ME\/CFS subgroup. A very important recently published study demonstrated that cerebral blood flow is reduced in ME\/CFS during head-up tilt testing even in the absence of hypotension or tachycardia [22]. This is consistent with our findings and may explain why ME\/CFS patients were not much more likely to meet standard criteria for POTS or OH than the HCs, even though they still became more symptomatic during the 10-minute NLT.<\/p>\n

Health Rising blog post<\/strong>: NASA Lean test, an easy way to diagnose Orthostatic Intolerance in ME\/CFS, Fibromyalgia and POTS<\/a>, by Cort Johnson<\/p>\n","protected":false},"excerpt":{"rendered":"

Hemodynamics during the 10-minute NASA Lean Test: evidence of circulatory decompensation in a subset of ME\/CFS patients by Jihyun Lee, Suzanne D Vernon, Patricia Jeys, Weam Ali, Andrea Campos, Derya Unutmaz, Brayden Yellman, Lucinda Bateman in J Transl Med. 2020 … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[3652,6167,1206,6166,618,1011,59,35,6170,6153,493,492,6169,6171,6168],"class_list":["post-27687","post","type-post","status-publish","format-standard","hentry","category-news","tag-abnormal-blood-circulation","tag-andrea-campos","tag-blood-flow","tag-brayden-yellman","tag-cort-johnson","tag-dr-derya-unutmaz","tag-dr-lucinda-bateman","tag-dr-suzanne-vernon","tag-haemodynamics","tag-jihyun-lee","tag-oi","tag-orthostatic-intolerance","tag-patricia-jeys","tag-ventricular-filling","tag-weam-ali"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-7cz","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27687","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=27687"}],"version-history":[{"count":4,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27687\/revisions"}],"predecessor-version":[{"id":27784,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/27687\/revisions\/27784"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=27687"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=27687"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=27687"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}