Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome
Abstract Brain perfusion is sensitive to changes in CO2 levels (CO2 reactivity). Previously, we showed a pathological cerebral blood flow (CBF) reduction in the majority of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients during orthostatic stress. Limited data are available on t...
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Physiological Reports |
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| Online Access: | https://doi.org/10.14814/phy2.15639 |
| _version_ | 1797364866151874560 |
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| author | C. (Linda) M. C. vanCampen Peter C. Rowe Freek W. A. Verheugt Frans C. Visser |
| author_facet | C. (Linda) M. C. vanCampen Peter C. Rowe Freek W. A. Verheugt Frans C. Visser |
| author_sort | C. (Linda) M. C. vanCampen |
| collection | DOAJ |
| description | Abstract Brain perfusion is sensitive to changes in CO2 levels (CO2 reactivity). Previously, we showed a pathological cerebral blood flow (CBF) reduction in the majority of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients during orthostatic stress. Limited data are available on the relation between CO2 and CBF changes in ME/CFS patients. Therefore, we studied this relation between ME/CFS patients and healthy controls (HC) during tilt testing. In this retrospective study, supine and end‐tilt CBF, as measured by extracranial Doppler flow, were compared with PETCO2 data in female patients either with a normal heart rate and blood pressure (HR/BP) response or with postural orthostatic tachycardia syndrome (POTS), and in HC. Five hundred thirty‐five female ME/CFS patients and 34 HC were included. Both in supine position and at end‐tilt, there was a significant relation between CBF and PETCO2 in patients (p < 0.0001), without differences between patients with a normal HR/BP response and with POTS. The relations between the %CBF change and the PETCO2 reduction were both significant in patients and HC (p < 0.0001 and p = 0.0012, respectively). In a multiple regression analysis, the patient/HC status and PETCO2 predicted CBF. The contribution of the PETCO2 to CBF changes was limited, with low adjusted R2 values. In female ME/CFS patients, CO2 reactivity, as measured during orthostatic stress testing, is similar to that of HC and is independent of the type of hemodynamic abnormality. However, the influence of CO2 changes on CBF changes is modest in female ME/CFS patients. |
| first_indexed | 2024-03-08T16:42:11Z |
| format | Article |
| id | doaj.art-83ec5dbf07ab4eda90de83d4e74633d2 |
| institution | Directory Open Access Journal |
| issn | 2051-817X |
| language | English |
| last_indexed | 2024-03-08T16:42:11Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Physiological Reports |
| spelling | doaj.art-83ec5dbf07ab4eda90de83d4e74633d22024-01-05T09:46:30ZengWileyPhysiological Reports2051-817X2023-09-011117n/an/a10.14814/phy2.15639Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndromeC. (Linda) M. C. vanCampen0Peter C. Rowe1Freek W. A. Verheugt2Frans C. Visser3Stichting CardioZorg Hoofddorp The NetherlandsDepartment of Paediatrics Johns Hopkins University School of Medicine Baltimore Maryland USAOnze Lieve Vrouwe Gasthuis (OLVG) Amsterdam The NetherlandsStichting CardioZorg Hoofddorp The NetherlandsAbstract Brain perfusion is sensitive to changes in CO2 levels (CO2 reactivity). Previously, we showed a pathological cerebral blood flow (CBF) reduction in the majority of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients during orthostatic stress. Limited data are available on the relation between CO2 and CBF changes in ME/CFS patients. Therefore, we studied this relation between ME/CFS patients and healthy controls (HC) during tilt testing. In this retrospective study, supine and end‐tilt CBF, as measured by extracranial Doppler flow, were compared with PETCO2 data in female patients either with a normal heart rate and blood pressure (HR/BP) response or with postural orthostatic tachycardia syndrome (POTS), and in HC. Five hundred thirty‐five female ME/CFS patients and 34 HC were included. Both in supine position and at end‐tilt, there was a significant relation between CBF and PETCO2 in patients (p < 0.0001), without differences between patients with a normal HR/BP response and with POTS. The relations between the %CBF change and the PETCO2 reduction were both significant in patients and HC (p < 0.0001 and p = 0.0012, respectively). In a multiple regression analysis, the patient/HC status and PETCO2 predicted CBF. The contribution of the PETCO2 to CBF changes was limited, with low adjusted R2 values. In female ME/CFS patients, CO2 reactivity, as measured during orthostatic stress testing, is similar to that of HC and is independent of the type of hemodynamic abnormality. However, the influence of CO2 changes on CBF changes is modest in female ME/CFS patients.https://doi.org/10.14814/phy2.15639carbon dioxidemyalgic encephalomyelitis/chronic fatigue syndromeorthostatic intolerancepostural hyperventilationtilt table test |
| spellingShingle | C. (Linda) M. C. vanCampen Peter C. Rowe Freek W. A. Verheugt Frans C. Visser Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome Physiological Reports carbon dioxide myalgic encephalomyelitis/chronic fatigue syndrome orthostatic intolerance postural hyperventilation tilt table test |
| title | Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome |
| title_full | Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome |
| title_fullStr | Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome |
| title_full_unstemmed | Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome |
| title_short | Influence of end‐tidal CO2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis/chronic fatigue syndrome |
| title_sort | influence of end tidal co2 on cerebral blood flow during orthostatic stress in controls and adults with myalgic encephalomyelitis chronic fatigue syndrome |
| topic | carbon dioxide myalgic encephalomyelitis/chronic fatigue syndrome orthostatic intolerance postural hyperventilation tilt table test |
| url | https://doi.org/10.14814/phy2.15639 |
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