Key result
Chronic fatigue syndrome was associated with reduced body size-adjusted liver volumes compared to controls.
Why the study?
Is liver volume reduced in patients with chronic fatigue syndrome compared to controls, and does it associate with blood pressure variability?
Case-Control (n=54)
Is liver volume reduced in patients with chronic fatigue syndrome compared to controls, and does it associate with blood pressure variability?
Patients with chronic fatigue syndrome have smaller liver volumes, which is independently associated with the return-to-baseline blood pressure on standing, suggesting the liver's role in blood pressure maintenance.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for liver volume differences in CFS; requires validation before any clinical or physiologic inferences.
Background: Chronic fatigue syndrome (CFS) in many cases is characterised by abnormal autonomic function and lower blood pressure (BP). In animals the liver is a capacitance vessel for BP homeostasis. We developed a novel liver magnetic resonance (MR) imaging technique to compare liver volume in CFS to controls, and to explore its role in cardiovascular physiology.Methods: Liver MR (single breath-hold, enhanced T1-weighted, high-resolution isotropic volume excitation 3-Tesla Achieva, NL) determined liver volume. Red cell and plasma volume were also measured. A 10 min resting cardiac autonomic assessment using beat-to-beat measurement (Taskforce; CNSystems) was followed by assessment of hemodynamic response to standing to determine blood pressure drop and return to baseline.Results: Forty-four CFS patients (age = 45.5, 34f/10 m, Fukuda criteria) and 10 age, activity and sex matched controls (age = 49.4, 7f/3 m) participated. Adjusted for body size, CFS patients had significantly reduced liver volumes (775 (101) ml/m2 v 846 (96) ml/m2; p = 0.02). At rest, liver volume was unrelated to symptom severity, heart rate, BP or heart rate variability. Both increased systolic and diastolic low frequency (LF) BP variability (predominantly sympathetic) were associated with lower liver volumes. On standing, liver volume was unrelated to BP drop but was associated with successful BP return-to-baseline. Red cell and plasma volume were associated positively with liver volume. Multivariate analysis confirmed return-to-baseline BP on standing which was independently associated with liver volume.Conclusion: Liver volumes were smaller in CFS compared to controls. The relationship between return-to-baseline BP after standing and liver volume suggests, as in animals, that the liver is involved in maintenance of BP.Abbreviations: ACI: Accelerated cardiac index; BPV: Blood pressure variability; BRS: Baroreflex sensitivity; CFS: chronic fatigue syndrome; Chr: Chromium; CI: cardiac index; FIS: Fatigue impact scale; HF: High frequency; HRV: Heart rate variability; LF: Low frequency; MR: magnetic resonance; NU: normalised units; SD: Standardised deviation; PSD: power spectral density; SI: Stroke index; TPRI: Total peripheral resistance index
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Zalewski et al. (2018) conducted a case-control in Chronic fatigue syndrome (n=54). Chronic fatigue syndrome vs. Matched controls was evaluated on Body size-adjusted liver volume (ml/m2) (p=0.02). Chronic fatigue syndrome was associated with reduced body size-adjusted liver volumes compared to controls.
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