2022
Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome A Randomized, Placebo-Controlled Trial of Pyridostigmine
Joseph P, Pari R, Miller S, Warren A, Stovall MC, Squires J, Chang CJ, Xiao W, Waxman AB, Systrom DM. Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome A Randomized, Placebo-Controlled Trial of Pyridostigmine. CHEST Journal 2022, 162: 1116-1126. PMID: 35526605, DOI: 10.1016/j.chest.2022.04.146.Peer-Reviewed Original ResearchConceptsME/CFSInvasive cardiopulmonary exercise testRight atrial pressureCardiac outputNeurovascular dysregulationAtrial pressurePostexertional malaiseExercise intoleranceMyalgic encephalomyelitis/chronic fatigue syndromePeak exercise oxygen uptakeRight ventricular filling pressuresEnd pointPlacebo-controlled trialPrimary end pointSecondary end pointsVentricular filling pressureCardiopulmonary exercise testChronic fatigue syndromeExercise oxygen uptakeA RandomizedIntractable fatigueOral pyridostigminePyridostigmine groupExercise capacitySystemic hemodynamics
2021
Insights From Invasive Cardiopulmonary Exercise Testing of Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Joseph P, Arevalo C, Oliveira RKF, Faria-Urbina M, Felsenstein D, Oaklander AL, Systrom DM. Insights From Invasive Cardiopulmonary Exercise Testing of Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. CHEST Journal 2021, 160: 642-651. PMID: 33577778, PMCID: PMC8727854, DOI: 10.1016/j.chest.2021.01.082.Peer-Reviewed Original ResearchConceptsSmall fiber neuropathyRight atrial pressurePostural orthostatic tachycardiaMyalgic encephalomyelitis/chronic fatigue syndromeCardiopulmonary exercise testingChronic fatigue syndromeExertional intoleranceExercise testingFatigue syndromeControl subjectsOxygen extractionInvasive cardiopulmonary exercise testingLow right atrial pressureME/CFS criteriaHigh pulmonary blood flowME/CFS patientsPeripheral oxygen extractionSmall fiber pathologyPulmonary blood flowSystemic oxygen extractionCardiac returnIntrinsic heartNeurovascular dysregulationRight shuntingCFS patients