2023
Exercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not?
Joseph P, Singh I, Oliveira R, Capone C, Mullen M, Cook D, Stovall M, Squires J, Madsen K, Waxman A, Systrom D. Exercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not? CHEST Journal 2023, 164: 717-726. PMID: 37054777, PMCID: PMC10088277, DOI: 10.1016/j.chest.2023.03.049.Peer-Reviewed Original ResearchConceptsMyalgic encephalomyelitis/chronic fatigue syndromeME/CFSChronic fatigue syndromeSARS-CoV-2Fatigue syndromePostacute sequelaeCardiopulmonary exercise testingSystemic blood flowExercise pathophysiologyExertional intoleranceIntractable fatigueExercise testingAcute infectionPostexertional malaiseExercise intoleranceOrthostatic intoleranceVentilatory controlLong-term consequencesBlood flowClinical overlapSuch symptomsIntoleranceSequelaeCOVID-19Syndrome
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
Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing
Singh I, Joseph P, Heerdt PM, Cullinan M, Lutchmansingh DD, Gulati M, Possick JD, Systrom DM, Waxman AB. Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing. CHEST Journal 2021, 161: 54-63. PMID: 34389297, PMCID: PMC8354807, DOI: 10.1016/j.chest.2021.08.010.Peer-Reviewed Original ResearchConceptsInvasive cardiopulmonary exercise testingCardiopulmonary exercise testingCardiopulmonary diseaseExercise testingControl participantsPeak VOExertional limitationCOVID-19Greater ventilatory inefficiencyPeak cardiac indexSex-matched control participantsCohort of patientsSystemic oxygen extractionDead space ventilationOnly mild symptomsExertional intoleranceCardiac indexPulmonary hemodynamicsAcute infectionVentilatory inefficiencyExercise intolerancePathophysiologic mechanismsMild symptomsHyperventilatory responseOxygen extractionInsights 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 ResearchMeSH KeywordsBiopsyExercise TestFatigue Syndrome, ChronicFemaleHumansMaleMiddle AgedPhenotypeSmall Fiber NeuropathyConceptsSmall 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