Naschitz, J E, Rosner, I, Rozenbaum, M et al. · QJM : monthly journal of the Association of Physicians · 2003 · DOI
Researchers developed a simple test using a tilting table to measure how well the body controls blood pressure and heart rate in ME/CFS patients. By tilting people upright and measuring these vital signs, they found a pattern (called a haemodynamic instability score) that appeared in ME/CFS patients but not in healthy people or those with other conditions. This test could help doctors confirm an ME/CFS diagnosis with objective measurements rather than relying only on symptoms.
This study offers the first objective physiological biomarker for ME/CFS diagnosis, addressing the long-standing clinical challenge of confirming diagnosis through subjective symptom assessment alone. The ability to distinguish ME/CFS dysautonomia from other conditions (fibromyalgia, anxiety, syncope) could accelerate diagnosis and reduce diagnostic delays, while providing a measurable endpoint for future treatment studies.
This study does not prove that HIS abnormalities cause ME/CFS or that they are specific to ME/CFS pathophysiology; it only demonstrates correlation with diagnosis. The cross-sectional design cannot establish whether HIS changes are fundamental to disease or secondary manifestations. Furthermore, the 22% test incompletion rate suggests the score may not be useful for more severely affected patients, and validation in independent cohorts is needed before clinical implementation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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