Department of Internal Medicine, Nanto Family and Community Medical Center, 577 Matsubara, Nanto, Toyama 939-1518, Japan.
J Cardiol. 2009 Aug;54(1):29-35. doi: 10.1016/j.jjcc.2009.02.008. Epub 2009 Mar 28.
"Small heart syndrome", previously referred to as so-called "neurocirculatory asthenia" associated with a small heart shadow on the chest roentgenogram, is characterized by weakness or fatigue even after mild exertion, palpitation, dyspnea, and fainting, many of which resemble symptoms in patients with chronic fatigue syndrome (CFS).
The study population comprised 42 patients with CFS younger than 40 years of age. Cardiothoracic ratio was determined on the chest roentgenogram and echocardiographic examination was performed to evaluate both the cardiac chamber size and function. "Small heart" (cardiothoracic ratio < or = 42%) on the chest X-ray photograph was noted in 26 (62%) of the study CFS patients. Echocardiographic examination demonstrated significantly smaller mean values of both the left ventricular (LV) end-diastolic and end-systolic dimensions, stroke volume indexes and cardiac indexes in CFS patients with "small heart" than in those without it and also in 20 control subjects. Thus, CFS patients with "small heart" had an actually small LV chamber and poor cardiac performance. During a long follow-up period of 10 CFS patients with "small heart", all echocardiographic parameters mentioned above improved and cardiothoracic ratios increased significantly during the remission phase as compared with exacerbation phase.
"Small heart" on the chest X-ray photograph was prevalently noted in CFS patients. Echocardiographic examination revealed that CFS patients with "small heart" had an actually small LV chamber and poor cardiac performance. Cardiac functional changes evaluated by repeated examinations appeared to be directly associated with the severity of their symptoms. Small heart syndrome with impaired cardiac function may contribute to the development of CFS through low cardiac output as a constitutional factor.
“小心脏综合征”，以前被称为所谓的“神经循环无力”，其特征是即使在轻度运动后也会出现虚弱或疲劳、心悸、呼吸困难和晕厥，其中许多症状与慢性疲劳综合征（CFS）患者相似。
研究人群包括 42 名年龄小于 40 岁的 CFS 患者。胸部 X 射线照片上的心胸比通过胸部 X 射线照片确定，并进行超声心动图检查以评估心脏腔室大小和功能。在研究中的 CFS 患者中，有 26 例（62%）出现胸部 X 射线照片上的“小心脏”（心胸比≤42%）。超声心动图检查显示，在有心胸小的 CFS 患者中，左心室（LV）舒张末期和收缩末期尺寸、每搏输出量指数和心输出量指数的平均值明显较小，与无心胸小的患者和 20 名对照者相比也是如此。因此，有心胸小的 CFS 患者的 LV 腔室实际上较小，心功能较差。在对 10 例有心胸小的 CFS 患者进行的长期随访中，与恶化期相比，在缓解期上述所有超声心动图参数均有所改善，心胸比显著增加。
胸部 X 射线照片上普遍注意到 CFS 患者有心胸小。超声心动图检查显示，有心胸小的 CFS 患者的 LV 腔室实际上较小，心功能较差。通过重复检查评估的心脏功能变化似乎与他们症状的严重程度直接相关。伴有心功能障碍的小心脏综合征可能通过作为一种体质因素的低心输出量促进 CFS 的发展。
