Capdevila, Lluis, Castro-Marrero, Jesús, Alegre, José et al. · Sensors (Basel, Switzerland) · 2021 · DOI
Researchers used a smartphone app connected to a heart monitor to measure heart rate variability (how much the time between heartbeats varies) in ME/CFS patients and healthy people. They found that women with ME/CFS showed different heart patterns than healthy women, but men with ME/CFS did not show the same clear difference. This suggests that ME/CFS may affect the heart's nervous system control differently in men versus women.
This study provides objective, non-invasive evidence that heart rate variability measured via accessible mobile technology may help identify autonomic dysfunction in ME/CFS, potentially offering a measurable biomarker for disease severity. The discovery of significant gender differences suggests that diagnostic and clinical evaluation strategies may need to be sex-specific, which could improve identification and monitoring of ME/CFS in both men and women.
This cross-sectional study cannot establish causation or confirm that HRV changes cause ME/CFS symptoms—only that associations exist. The study does not prove that HRV can predict disease progression, despite authors' suggestions, as longitudinal follow-up data is absent. Results cannot be generalized to all ME/CFS populations due to the small sample size and potential selection bias in study recruitment.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Capdevila, Lluis, Castro-Marrero, Jesús, Alegre, José, Ramos-Castro, Juan, & Escorihuela, Rosa M (2021). Analysis of Gender Differences in HRV of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Using Mobile-Health Technology.. Sensors (Basel, Switzerland). https://doi.org/10.3390/s21113746
BibTeX
@article{mecfsatlas-capdevila-2021-analysis-gender,
author = {Capdevila, Lluis and Castro-Marrero, Jesús and Alegre, José and Ramos-Castro, Juan and Escorihuela, Rosa M},
title = {Analysis of Gender Differences in HRV of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Using Mobile-Health Technology.},
journal = {Sensors (Basel, Switzerland)},
year = {2021},
doi = {10.3390/s21113746},
note = {PubMed: 34071326},
url = {https://www.mecfsatlas.com/evidence/capdevila-2021-analysis-gender},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/capdevila-2021-analysis-gender
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