Nelson Maximillian J, Bahl Jasvir S, Buckley Jonathan D, Thomson Rebecca L, Davison Kade
Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia.
Adelaide Medical School and Robinson Research Institute, University of Adelaide, Adelaide, Australia.
Medicine (Baltimore). 2019 Oct;98(43):e17600. doi: 10.1097/MD.0000000000017600.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex condition with no reliable diagnostic biomarkers. Studies have shown evidence of autonomic dysfunction in patients with ME/CFS, but results have been equivocal. Heart rate (HR) parameters can reflect changes in autonomic function in healthy individuals; however, this has not been thoroughly evaluated in ME/CFS.
A systematic database search for case-control literature was performed. Meta-analysis was performed to determine differences in HR parameters between ME/CFS patients and controls.
Sixty-four articles were included in the systematic review. HR parameters assessed in ME/CFS patients and controls were grouped into ten categories: resting HR (RHR), maximal HR (HRmax), HR during submaximal exercise, HR response to head-up tilt testing (HRtilt), resting HR variability (HRVrest), HR variability during head-up tilt testing (HRVtilt), orthostatic HR response (HROR), HR during mental task(s) (HRmentaltask), daily average HR (HRdailyaverage), and HR recovery (HRR) Meta-analysis revealed RHR (MD ± 95% CI = 4.14 ± 1.38, P < .001), HRtilt (SMD ± 95% CI = 0.92 ± 0.24, P < .001), HROR (0.50 ± 0.27, P < .001), and the ratio of low frequency power to high frequency power of HRVrest (0.39 ± 0.22, P < .001) were higher in ME/CFS patients compared to controls, while HRmax (MD ± 95% CI = -13.81 ± 4.15, P < .001), HR at anaerobic threshold (SMD ± 95% CI = -0.44 ± 0.30, P = 0.005) and the high frequency portion of HRVrest (-0.34 ± 0.22, P = .002) were lower in ME/CFS patients.
The differences in HR parameters identified by the meta-analysis indicate that ME/CFS patients have altered autonomic cardiac regulation when compared to healthy controls. These alterations in HR parameters may be symptomatic of the condition.
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）是一种复杂的病症，尚无可靠的诊断生物标志物。研究已显示ME/CFS患者存在自主神经功能障碍的证据，但结果并不明确。心率（HR）参数可反映健康个体自主神经功能的变化；然而，这在ME/CFS中尚未得到充分评估。
对病例对照文献进行系统的数据库检索。进行荟萃分析以确定ME/CFS患者与对照组之间HR参数的差异。
系统评价纳入了64篇文章。在ME/CFS患者和对照组中评估的HR参数分为十类：静息心率（RHR）、最大心率（HRmax）、次最大运动时的心率、对抬头倾斜试验的心率反应（HRtilt）、静息心率变异性（HRVrest）、抬头倾斜试验期间的心率变异性（HRVtilt）、直立性心率反应（HROR）、心理任务期间的心率（HRmentaltask）、每日平均心率（HRdailyaverage）和心率恢复（HRR）。荟萃分析显示，与对照组相比，ME/CFS患者的RHR（MD±95%CI = 4.14±1.38，P <.001）、HRtilt（SMD±95%CI = 0.92±0.24，P <.001）、HROR（0.50±0.27，P <.001）以及HRVrest的低频功率与高频功率之比（0.39±0.22，P <.001）更高，而ME/CFS患者的HRmax（MD±95%CI = -13.81±4.15，P <.001）、无氧阈值时的心率（SMD±95%CI = -0.44±0.30，P = 0.005）和HRVrest的高频部分（-0.34±0.22，P =.002）更低。
荟萃分析确定的HR参数差异表明，与健康对照组相比，ME/CFS患者的自主心脏调节发生了改变。这些HR参数的改变可能是该病症的症状表现。
