Cardiac Insufficiency Hypothesis




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There is new research from a New Jersey team, authored by Doctors Arnold Peckerman, Benjamin Natelson et al., which found left-ventricular dysfunction following exertion and orthostatic stress in patients with myalgic encephalomyelitis/chronic fatigue syndrome. The WedMD article and the press release are available at the link below. In an NIH-funded study on impedance cardiography also linked below, Peckerman and Natelson found that low cardiac output correlated with symptom severity in ME/CFS.

Dr. A. Martin Lerner holds U.S. patents for the diagnosis of  ME/CFS in the chronic mononucleosis subset of this disease using 24-hour Holter monitoring.  He argues that a prominent subset of the disease is a prolonged, chronic mononucleosis following infection with Epstein Barr virus (EBV), Human  Cytomegalovirus (HCMV), or both, and/or possibly Human Herpes Virus 6 (HHV-6).   Viral infection persists in the heart, causing left-ventricular dysfunction, producing exercise intolerance.  Exercise, in turn, worsens the cardiac dysfunction.  He has also postulated that the disease is an early dilated cardiomyopathy that in later stages might result in progressive, end-stage dilated cardiomyopathy, a type of heart failure.  Dilated cardiomyopathy is sometimes viewed as "idiopathic," or "Idiopathic Dilated Cardiomyopathy" (IDC).  In an editorial response titled "Microbial Persistence and Idiopathic Dilated Cardiomyopathy," Dr. Lerner has postulated that these viruses may be the etiological link. 

More recently, physicist, physician, long-time ME/CFS researcher and clinician, and heart-transplant recipient Paul Cheney, M.D., Ph.D., has offered an alternative theory that a subset of ME/CFS patients suffer from a diastolic cardiomyopathy, a problem with ventricular filling resulting from mitochondrial dysfunction and low ATP energy in the heart.

To view a streaming video of a three-hour talk by Dr. Cheney on diastolic cardiomyopathy and ME/CFS, click here. This video can be accessed with a broadband connection only. The video cannot be properly viewed using a dial-up modem. Because there may be many people trying to access the video at once, our server may become temporarily overloaded. Please try back again if you encounter this problem or if the video does not play for the full three hours. Note that some of the most informative parts of this three-hour talk occur in the second half when Dr. Cheney discusses and shows charts on cardiac output in litres per minute, comparing ME/CFS patients with controls. To purchase a videocassette of this seminar by Dr. Cheney from the Dallas-Fort Worth CFS group, click here. A detailed discussion of Dr. Cheney's views is available below in an interview by Carol Sieverling, and is recommended reading along with the Peckerman/Natelson article on impedance cardiography for those who want to study the insightful issues addressed in the video. To purchase a DVD set of another talk by Dr. Cheney illustrating more recent echocardiographic and other objective data on ME/CFS and heart failure, click here.

Some of Dr. Lerner's significant articles, as well as his patent issued in 2002, are linked below in Portable Document File (PDF) format. These files require an Adobe Acrobat Reader. Most computers come with this program preloaded.  If not, a free Acrobat Reader can be downloaded here.

New Research on Cardiac Insufficiency

VanNess JM, Snell CR, Stevens SR, "Diminished Cardiopulmonary Capacity During Post-Exertional Malaise," Journal of Chronic Fatigue Syndrome, Vol. 14, No. 2, 2007, pp. 77-85 [PDF]

Wyller VB, Due R, Saul JP, Amlie JP, Thaulow E., "Usefulness of an abnormal cardiovascular response during low-grade head-up tilt-test for discriminating adolescents with chronic fatigue from healthy controls," Am J Cardiol. 2007 Apr 1;99(7):997-1001. [PDF]

Information on the study "Left Ventricular Function in Chronic Fatigue Syndrome (CFS): Data From Nuclear Ventriculography Studies of Response to Exercise and Postural Stress," by Arnold Peckerman, Benjamin Natelson et al. [This study found that the heart failed to pump enough blood following exertion and upright posture in the CFS patients that were studied.]

Peckerman A, LaManca JJ, Dahl KA, Chemitiganti R, Qureishi B, Natelson BH. "Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome." Am J Med Sci. 2003 Aug;326(2):55-60.

Arnold Peckerman, PhD, John J. LaManca, PhD, Bushra Qureishi, MD, Kristina A. Dahl, MD, Roseli Golfetti, PhD, Yoshiharu Yamamoto, PhD and Benjamin H. Natelson, "Baroreceptor Reflex and Integrative Stress Responses in Chronic Fatigue Syndrome." Psychosomatic Medicine 65:889-895 (2003)  

Myhill S, Booth NE, McLaren-Howard, J., "Chronic fatigue syndrome and mitochondrial dysfunction,". Int J Clin Exp Med (2009) 2, 1-16 [PDF Format]

Dr. Sarah Myhill, "CFS is Heart Failure Secondary to Mitochondrial Malfunction." Pamphlet. [PDF Format]

Carol Sieverling, "The Heart of the Matter: CFS & Cardiac Issues." Dr. Paul Cheney's theoretical insights on ME/CFS and heart failure. Pamphlet. [PDF Format]

Dr. Paul Cheney, "CFS and Diastolic Cardiomyopathy" [A three-hour talk in streaming video for viewing on the Web with a broadband connection only, not a dial-up connection.]

Mihai Gheorghiade; William T. Abraham; Nancy M. Albert; Barry H. Greenberg; Christopher M. O’Connor; Lilin She; Wendy Gattis Stough; Clyde W. Yancy; James B. Young; Gregg C. Fonarow; for the OPTIMIZE-HF Investigators and Coordinators, "Systolic Blood Pressure at Admission, Clinical Characteristics, and Outcomes in Patients Hospitalized With Acute Heart Failure," JAMA. 2006;296:2217-2226. [PDF Format]

Francesca Bursi; Susan A. Weston; Margaret M. Redfield; Steven J. Jacobsen; Serguei Pakhomov; Vuyisile T. Nkomo; Ryan A. Meverden; Véronique L. Roger, "Systolic and Diastolic Heart Failure in the Community," JAMA. 2006;296:2209-2216. [PDF Format]

Gerard P. Aurigemma, M.D., "Diastolic Heart Failure — A Common and Lethal Condition by Any Name," NEJM, Volume 355:308-310. [PDF Format]

Theophilus E. Owan, M.D.,et al., "Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction," NEJM, Volume 355:251-259. [PDF Format]

R. Sacha Bhatia, M.D., M.B.A., et al., "Outcome of Heart Failure with Preserved Ejection Fraction in a Population-Based Study," NEJM, Volume 355:260-269. [PDF Format]


Lerner Articles and Patent

Lerner AM, Dworkin HJ, Sayyed T, et al.,"Prevalence of abnormal cardiac wall motion in the cardiomyopathy associated with incomplete multiplication of Epstein-barr Virus and/or cytomegalovirus in patients with chronic fatigue syndrome". In Vivo 2004 Jul-Aug;18(4):417-24. [PDF Format]

Lerner, A.M.  "Editorial Response: Microbial Persistence and Idiopathic Dilated Cardiomyopathy."  Clinical Infectious Diseases (1999):29:526-7. [PDF Format]

Lerner, A. M., Goldstein, J., O'Neill W., et al. "Cardiac involvement in patients with chronic fatigue syndrome as documented with Holter and biopsy data in Birmingham, Michigan, 1991-1993." Inf Dis in Clin Pract, 1997; 6:327-333. [PDF Format]

Lerner, A. M., Zervos, M., Dworkin H.J., et al. "New cardiomyopathy: a pilot study of intravenous gancyclovir in a subset of the chronic fatigue syndrome." Inf Dis in Clin Pract, 1997; 6:239-43. [PDF Format]

Lerner, A.M., et al. "IgM Serum Antibodies to Human Cytomegalovirus Nonstructural Gene Products p52 and CM2 (UL44 and UL57) are Uniquely Present in a Subset of Patients with Chronic Fatigue Syndrome."  In Vivo 16:153-160 (2002). [PDF Format]

Lerner AM, Beqaj SH, Deeter RG, Fitzgerald JT. "IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome," In Vivo. 2004 Mar-Apr;18(2)101-6. [PDF Format]

U.S. Patent issued to Dr. Lerner on June 4, 2002, for a "Method for Diagnosing and alleviating the symptoms of chronic fatigue syndrome." [PDF Format]


Hawthorn Extract

Pittler MH, Schmidt K, Ernst E., Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med. 2003 Jun 1;114(8):665-74. [PDF Format]

[Note: The M.E. Society of America does not recommend treatments for ME/CFS or for any other disease. We are providing this article on Hawthorn for heart failure for informational purposes only. Patients should consult with their licensed healthcare professional about their own healthcare needs.]






© Copyright 2003-2009 M.E. Society of America
Page last updated: February 22, 2009


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