{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T22:42:17Z","timestamp":1770072137735,"version":"3.49.0"},"reference-count":58,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Orthostatic intolerance is prevalent in patients with myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) and is caused by an abnormal reduction in cerebral blood flow (CBF). In healthy controls (HCs), CBF is regulated complexly, and cardiac output (CO) is an important determinant of CBF. A review in HC showed that a 30% reduction in CO results in a 10% reduction in CBF. In contrast, we showed in ME\/CFS patients with a normal HR (HR) and blood pressure response during a tilt test that CO and CBF decreased to a similar extent. The relation between CO and CBF in ME\/CFS patients with postural orthostatic tachycardia syndrome (POTS) is unknown. Therefore, the aim of this study is to assess the relation between CBF and CO, in ME\/CFS patients with POTS. The methods used in this retrospective study analyze this relation in a large group of patients. We also analyzed the influence of clinical data. A total of 260 ME\/CFS patients with POTS underwent tilt testing with measurements of HR, BP, CBF, CO, and end-tidal PCO2. We measured CBF using extracranial Doppler flow velocity and vessel diameters obtained with a General Electric echo system, and suprasternal aortic flow velocities were measured using the same device. We recorded end-tidal PCO2 using a Nonin Lifesense device. Results: End-tilt HR and the HR increase were significantly higher in the patients with a %CO reduction \u2265 \u221215% than in the other group. End-tilt CO was higher and the %CO reduction was lower in patients with %CO reduction \u2265 \u221215% than in the other group. CBF data (supine, end-tilt and the %CBF reduction) were not different between the two patient groups. The use of HR increases and %SV reductions were not as discriminative as the %CO reduction. Conclusions: In ME\/CFS patients with POTS during tilt testing with measurements of both the CO and the CBF, two different patterns were observed: (1) appr. two-thirds of patients had an almost 1:1 relation between the %CBF reduction and the %CO reduction. (2) Appr. one-third of patients showed a limited reduction in CO together with a substantial increase in HR. In these patients, there was no relation between the CO and CBF reduction. These data suggest the presence of a hyperadrenergic response.<\/jats:p>","DOI":"10.3390\/jcm14113648","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T12:15:43Z","timestamp":1747916143000},"page":"3648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Relation Between Cardiac Output and Cerebral Blood Flow in ME\/CFS Patients with a POTS Response During a Tilt Test"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2570-0914","authenticated-orcid":false,"given":"C. (Linda) M. C.","family":"van Campen","sequence":"first","affiliation":[{"name":"Stichting CardioZorg, Kraayveld 5, 1171 JE Badhoevedorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frans C.","family":"Visser","sequence":"additional","affiliation":[{"name":"Stichting CardioZorg, Kraayveld 5, 1171 JE Badhoevedorp, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97149","DOI":"10.5492\/wjccm.v13.i4.97149","article-title":"Regional dynamic cerebral autoregulation across anterior and posterior circulatory territories: A detailed exploration and its clinical implications","volume":"13","author":"Srichawla","year":"2024","journal-title":"World J. Crit. 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