CFS News  

I have included this 2002 study as it would seem there are some in the medical profession in Australia are as yet unaware of it. Remember for your Physician to keep abreast of all studies and research, there would be little if any time to see patients.

The head-up tilt test with haemodynamic instability score in diagnosing CFS.

Quarterly Journal of Medicine, 2003, 96, 2, 133-142.
Naschitz, JE., Rosner, I., Rozenbaum, M., Naschitz, S., Musafia-Priselac, R., Shaviv, N., Fields, M., Isseroff, H., Zuckerman, E., Yeshurun, D and Sabo, E.

Studying patients with CFS, we have developed a method that uses a head-up tilt test (HUTT) to estimate BP and HR instability during tilt, expressed as a 'haemodynamic instability score' (HIS). Aim: To assess HIS sensitivity and specificity in the diagnosis of CFS.

Prospective controlled study.

Patients with CFS (n=40), non-CFS chronic fatigue (n=73), fibromyalgia (n=41), neurally mediated syncope (n=58), generalized anxiety disorder (n=28), familial Mediterranean fever (n=50), arterial hypertension (n=28), and healthy subjects (n=59) were evaluated with a standardized HUTT. The HIS was calculated from blood pressure (BP) and heart rate (HR) changes during the HUTT.

The tilt was prematurely terminated in 22% of CFS patients when postural symptoms occurred and the HIS could not be calculated. In the remainder, the median (IQR) HIS values were: CFS +2.14 (4.67), non-CFS fatigue -3.98 (5.35), fibromyalgia -2.81 (2.62), syncope -3.7 (4.36), generalized anxiety disorder -0.21 (6.05), healthy controls -2.66 (3.14), FMF -5.09 (6.41), hypertensives -5.35 (2.74) (p<0.0001 vs. CFS in all groups, except for anxiety disorder, p=ns). The sensitivity for CFS at HIS >-0.98 cut-off was 90.3% and the overall specificity was 84.5%.

There is a particular dysautonomia in CFS that differs from dysautonomia in other disorders, characterized by HIS >-0.98. The HIS can reinforce the clinician's diagnosis by providing objective criteria for the assessment of CFS, which until now, could only be subjectively inferred.

From the Discussion section
The HIS was characteristic of the diagnosis of dysautonomia in CFS, and distinguished CFS from several disorders that either display clinical similarity with CFS or in which dysautonomia is known to be present. The 90.3% sensitivity and 84.5% overall specificity of HIS for CFS contrasts with the merely moderate sensitivity and poor specificity of classical autonomic testing for CFS.3–8,15–17 Though direct intraneural measurement of the efferent sympathetic nerve traffic to blood vessels, combined with spectral analysis of cardiovascular reactivity during rest and postural challenge, has advanced our understanding of the pathophysiology of dysautonomia,40 these data are not specific for CFS and have no application in the diagnosis of CFS.41,42

Full Study(pdf)