Abstract
Introduction: Among the main characteristics of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of ME/CFS symptoms. The gold standard for measuring the severity of physical activity intolerance is cardiopulmonary exercise testing (CPET). Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients. A consecutive day CPET protocol has shown a difference on day 2 in ME/CFS patients in contrast to sedentary controls. Because of the low number of male ME/CFS patients in the published literature, and because of a possible gender difference in the clinical phenotype, the aim of this study was to examine whether the response to a 2-day CPET protocol in a larger sample of male ME/CFS patients was similar to that observed in females. Methods: From 77 male patients, 25 male ME/CFS patients fulfilled the criteria of a 2-day CPET protocol for analysis. Measures of oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER) were made at maximal (peak) and ventilatory threshold (VT) intensities. Data were analysed using a paired t-test. Results: Baseline characteristics of the group were as follows. Mean age was 44 (12) years, mean BMI was 27.1 (4.4) kg/m2. Median disease duration was 10 years (IQR 7 - 13). Heart rate, systolic and diastolic blood pressure at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between 2 and workload at peak exercise and ventilatory threshold. Conclusion: This study confirms that male ME/CFS patients have a reduction in exercise capacity in response to a consecutive day CPET. These results are similar to published results in female ME/CFS populations.
Highlights
Among the main characteristics of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of ME/CFS symptoms
Because of the low number of male ME/CFS patients in the published literature, and because of a possible gender difference in the clinical phenotype, the aim of this study was to examine whether the response to a 2-day cardiopulmonary exercise testing (CPET) protocol in a larger sample of male ME/CFS patients was similar to that observed in females
A two day CPET protocol in ME/CFS patients shows a unique feature of the disease: that the oxygen consumption VO2 ventilatory threshold (VT) (VO2) peak and at the ventilatory threshold are reduced at the second day which is in contrast to the VO2 data in sedentary controls (Lien et al, 2019; Nelson et al, 2019; Snell et al, 2013; Vanness et al, 2007; Vermeulen et al, 2010)
Summary
Among the main characteristics of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of ME/CFS symptoms. Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients. One of the main characteristics of patients with ME/CFS is effort intolerance along with a prolonged recovery from exercise and post-exertional exacerbation of ME/CFS symptoms (IOM, 2015), termed post-exertional malaise (PEM) (Jones et al, 2010; Paul et al, 1999). Studies have shown that a single CPET may show in ME/CFS patients that peak VO2 values can be similar to or only slightly lower than those of healthy sedentary controls. Sedentary controls have unaltered or slightly improved VO2 and workload (Keller et al, 2014; Lien et al, 2019; Nelson et al, 2019; Snell et al, 2013; Vanness et al, 2007; Vermeulen et al, 2010)
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