PT  - JOURNAL ARTICLE
AU  - Julia L Newton
AU  - Andreas Finkelmeyer
AU  - George Petrides
AU  - James Frith
AU  - Tim Hodgson
AU  - Laura Maclachlan
AU  - Guy MacGowan
AU  - Andrew M Blamire
TI  - Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study
AID  - 10.1136/openhrt-2015-000381
DP  - 2016 Jun 01
TA  - Open Heart
PG  - e000381
VI  - 3
IP  - 1
4099  - http://openheart.bmj.com/content/3/1/e000381.short
4100  - http://openheart.bmj.com/content/3/1/e000381.full
SO  - Open Heart2016 Jun 01; 3
AB  - Objectives To explore potential mechanisms that underpin the cardiac abnormalities seen in chronic fatigue syndrome (CFS) using non-invasive cardiac impedance, red cell mass and plasma volume measurements.Methods Cardiac MR (MR) examinations were performed using 3 T Philips Intera Achieva scanner (Best, NL) in participants with CFS (Fukuda; n=47) and matched case-by-case controls. Total volume (TV), red cell volume (RCV) and plasma volume (PV) measurements were performed (41 CFS and 10 controls) using the indicator dilution technique using simultaneous 51-chromium labelling of red blood cells and 125-iodine labelling of serum albumin.Results The CFS group length of history (mean±SD) was 14±10 years. Patients with CFS had significantly reduced end-systolic and end-diastolic volumes together with reduced end-diastolic wall masses (all p<0.0001). Mean±SD RCV was 1565±443 mL with 26/41 (63%) having values below 95% of expected. PV was 2659±529 mL with 13/41 (32%) <95% expected. There were strong positive correlations between TV, RCV and PV and cardiac end-diastolic wall mass (all p<0.0001; r2=0.5). Increasing fatigue severity correlated negatively with lower PV (p=0.04; r2=0.2). There were no relationships between any MR or volume measurements and length of history, suggesting that deconditioning was unlikely to be the cause of these abnormalities.Conclusions This study confirms an association between reduced cardiac volumes and blood volume in CFS. Lack of relationship between length of disease, cardiac and plasma volumes suggests findings are not secondary to deconditioning. The relationship between plasma volume and severity of fatigue symptoms suggests a potential therapeutic target in CFS.