Low birth weight, diastolic heart failure and CFS – Is there a connection?

Two published studies show that diastolic heart failure (DHF) in the elderly and low birth weights at term in infants have occurred during the same time frame from 1990-2000. No one has an explanation for these anomalies at the ends of the age spectrum in humans but suspect an environmental factor or factors. We have a rising case load of diastolic dysfunction seen in 97% of our CFS cases (ave. age 49) and some appear to have what I would call compensated diastolic heart failure. I would define compensated DHF in CFS as an extremely low cardiac output with a cardiac index (CI) below 2.0 and very poor functional capacity combined with the inability to stand which is the corollary in DHF to the inability to lay down flat in systolic heart failure (SHF). Heart failure patients are typically below 2.0 in CI. I have several CFS patients below that number and they cannot stand still for more than 15-30 seconds without having to sit down or fall down. Walking or moving helps which makes sense as that would increase filling pressures and equivalent to laying down. They might be diagnosed as having orthostatic intolerance by others. These patients are also typically thin or near ideal body weight and have a high catabolic to anabolic ratio on 24 hour urine hormone analysis when I have measured it.

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