Dr. Francisco Westermeier is an ME/CFS researcher at the FH JOANNEUM University of Applied Sciences (Austria) and a 2019 Solve Ramsay Grant Awardee. He specializes in how ME/CFS disease affects cardiometabolic health—which is the proper functioning of the heart and blood vessels—and how this relates to metabolism (processing food into high-energy metabolites). Examples of cardiometabolic health variables include heart rate and stroke volume (how much blood the heart pumps with each beat); arterial, diastolic, and systolic blood pressures; and basal metabolic rate.
In a recent Solve-funded study published in Heliyon, Dr. Westermeier’s team asked how cardiometabolic functions differ between people with ME/CFS and healthy people and between women and men. The team also examined key factors related to both ME/CFS and cardiometabolic health. These included physical stress (by comparing measurements of participants seated with those of ones standing); oxidative stress (by measuring a blood-based oxidative stress marker); body composition (e.g., body mass index, body fat, body muscle); and metabolites.
The team found that ME/CFS affected cardiometabolic health of women differently from how it affected the health of men. On the one hand, the average heart rate of women with ME/CFS was significantly faster than that of healthy women, regardless of whether the women were sitting or standing. And when standing, women with ME/CFS had on average a significantly lower stroke volume and a significantly lower pulse pressure index than did healthy women who were standing. Also, while body mass index correlated with diastolic and arterial blood pressures in healthy women (as expected), it did not for women with ME/CFS. This suggests that ME/CFS disrupts how body composition relates to cardiovascular functions in women, which is important because this may be a critical physiological factor for disease-associated post-exertional malaise.
For men, on the other hand, heart rate and stroke volume for participants with ME/CFS were the same as for healthy participants. But diastolic blood pressure and oxidative stress for men with ME/CFS were both significantly higher than for healthy men, regardless of whether participants were sitting or standing. And when standing, men with ME/CFS had on average a significantly higher arterial blood pressure than healthy men who were standing.
Overall, some features that predicted whether women had ME/CFS (body fat, body mass index, cardiac index, heart rate when standing, stroke volume index) differed from the ones that predicted whether men had ME/CFS (oxidative stress, pulse pressure index when standing). These differences suggest that sex and posture (being seated or standing upright) both significantly influence cardiometabolic health in people with ME/CFS.
These results are important because they suggest ways to best study cardiometabolic health and to treat people with ME/CFS. For example, future studies of how ME/CFS affects cardiometabolic health should consider participants’ sex and posture (which is an important conclusion because most earlier cardiometabolic studies have not explicitly considered these influences when interpreting results). And future clinical trials of antioxidant treatments for ME/CFS should consider whether such treatments help men with ME/CFS more than women with ME/CFS, since in this study the oxidative stress for men was more severe than that for women.
The research team noted their study had room for improvement. First, the team’s model of cardiometabolic factors related to ME/CFS disease in women was sensitive but not especially accurate. Follow-up studies that enroll more women than here and that track functions over time may yield more accurate models. For example, these studies may find important cardiometabolic variables overlooked in this study. Also, for this study the team induced physical stress by having participants stand for a minute. But future studies may use more informative and demanding posture-based challenges, like the NASA 10-Minute Lean Test.
Dr. Westermeier noted, “We hope to better understand post-exertional malaise (PEM) and certain cardiometabolic traits observed in people with ME/CFS. Our goal is to improve patient stratification by considering key variables such as sex, disease duration, and severity. This approach could help identify more precise biological patterns and support better clinical management of patients in the future.”
Why This Study Matters to the Patient Community:
- Indicates key questions to guide future clinical trials: Clarifies how ME/CFS clinical trials related to cardiometabolic functions must carefully consider participants’ posture during examinations (whether participants are seated or standing) and sex.
- Lays the Groundwork for Preventive Treatments: Suggests antioxidants may help men with ME/CFS more than women with ME/CFS.
- Suggests a physiological reason for key ME/CFS symptoms for some people: Reveals how ME/CFS cardio metabolic dysregulation (e.g., disconnection of body composition from cardiovascular regulation in women) may contribute to ME/CFS symptoms (especially post-exertional malaise).
Dr. Westermeir told us that his 2019 Solve Ramsay Research Grant was key to starting his research line, noting, “When we received it, before the pandemic, there was limited evidence and very little funding focused on the cardiovascular aspects of ME/CFS. This support allowed us to begin exploring how cardiovascular abnormalities contribute to the disease, opening new perspectives and collaborations that now extend into other areas, including Long Covid. Solve’s Ramsay Grant provided the initial resources to translate our scientific ideas into concrete experiments and to establish collaborative networks that now play a key role in our research.”
He added, “As a team, we are deeply grateful to all donors and patients who make the Ramsay Program possible. Your support motivates us to keep exploring new scientific questions and to study aspects of ME/CFS that have not yet been fully explored. Thanks to your commitment, we are strengthening the foundations needed to better understand these devastating conditions that affect not only the lives of those who suffer from them, but also their families and close circles.”
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