De Lorenzo, F, Xiao, H, Mukherjee, M et al. · QJM : monthly journal of the Association of Physicians · 1998 · DOI
This study compared the hearts and bodies of 273 ME/CFS patients with 72 healthy people. Researchers found that ME/CFS patients had smaller hearts and blood vessels, along with changes in blood markers like cholesterol and blood cells. The study suggests that ME/CFS patients may experience physical deconditioning similar to what happens when people are very inactive.
This study provides objective evidence of measurable cardiovascular structural changes in ME/CFS, moving beyond subjective symptom reporting. Understanding whether these changes reflect deconditioning versus primary disease pathology has important implications for treatment approaches and the safety of exercise interventions in this population.
This study does not prove that exercise would be safe or beneficial for ME/CFS patients, as it cannot distinguish whether observed changes are cause or consequence of reduced activity. The cross-sectional design means we cannot determine if deconditioning preceded ME/CFS or developed after symptom onset. This study also does not establish whether the cardiovascular changes are reversible or what role post-exertional malaise might play.
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
De Lorenzo, F, Xiao, H, Mukherjee, M, Harcup, J, Suleiman, S, Kadziola, Z, et al. (1998). Chronic fatigue syndrome: physical and cardiovascular deconditioning.. QJM : monthly journal of the Association of Physicians. https://doi.org/10.1093/qjmed/91.7.475
BibTeX
@article{mecfsatlas-de-lorenzo-1998-chronic-fatigue,
author = {De Lorenzo, F and Xiao, H and Mukherjee, M and Harcup, J and Suleiman, S and Kadziola, Z and Kakkar, V V},
title = {Chronic fatigue syndrome: physical and cardiovascular deconditioning.},
journal = {QJM : monthly journal of the Association of Physicians},
year = {1998},
doi = {10.1093/qjmed/91.7.475},
note = {PubMed: 9797930},
url = {https://www.mecfsatlas.com/evidence/de-lorenzo-1998-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/de-lorenzo-1998-chronic-fatigue
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