Cardiac Involvement in Patients with Chronic Fatigue Syndrome as Documented with Holter and Biopsy Data in Birmingham, Michigan, 1991-1993

Abstract

We report the prevalence of abnormal oscillating T-waves at Holter monitoring in a consecutive case series of 67 chronic fatigue syndrome (CFS) patients from an infectious diseases center in Birmingham, Michigan, in the years 1991-1993 , and compare these abnormal T-waves to similar tests in 78 non-CFS patients matched for age, place, time, and the absence of known other confounding medical diseases. Patients in both groups had normal resting 12-lead electrocardiograms (ECGs), rest/stress myocardial perfusion studies (thallium 201 or TC-99 sestamibi studies and two-dimensional echocardiograms (except for the incidental findings of mitral valve prolapse without significant regurgitation or, an incidental nonsignificant aortic stenosis). The prevalence of labile Twave abnormalities by Holter monitoring was greater in CFS patients than in non-CFS patients (P<.01). Repetitive T-wave flattening was a sensitive indicator of the presence of CFS. The absence of these abnormal T-waves made the diagnosis of CFS unlikely (statistical sensitivity, 0.96). The combination (e.g., the presence of both oscillating Twave flattenings plus T-wave inversions) was an accurate indicator of the possible presence of CFS. Right ventricular endomyocardial biopsies in CFS patients showed a single patient with lymphocytic myocarditis. Light and electron microscopic cardiomyopathic changes were present in the others. Copywrite 1997 Williams & Wilkins