Cardiac Insufficiency Hypothesis
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.