Escorihuela, Rosa María, Capdevila, Lluís, Castro, Juan Ramos et al. · Journal of translational medicine · 2020 · DOI
This study measured how the heart rate varies between beats in people with ME/CFS compared to healthy people. Researchers found that people with ME/CFS have less variation in their heart rate and that this reduced variation is connected to how severe their fatigue is. The findings suggest that an overactive stress response in the nervous system may contribute to fatigue severity.
HRV could serve as an objective, non-invasive biomarker to help clinicians assess ME/CFS severity and autonomic dysfunction, potentially improving diagnosis and monitoring. Understanding the link between nervous system dysfunction and fatigue severity may guide future treatments targeting autonomic regulation in ME/CFS.
This study cannot prove that reduced HRV causes fatigue; it only shows an association. The findings are limited to women and cannot be generalized to male patients with ME/CFS. A single cross-sectional measurement does not establish whether HRV changes precede fatigue or result from it.
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
Escorihuela, Rosa María, Capdevila, Lluís, Castro, Juan Ramos, Zaragozà, María Cleofé, Maurel, Sara, Alegre, José, et al. (2020). Reduced heart rate variability predicts fatigue severity in individuals with chronic fatigue syndrome/myalgic encephalomyelitis.. Journal of translational medicine. https://doi.org/10.1186/s12967-019-02184-z
BibTeX
@article{mecfsatlas-escorihuela-2020-reduced-heart,
author = {Escorihuela, Rosa María and Capdevila, Lluís and Castro, Juan Ramos and Zaragozà, María Cleofé and Maurel, Sara and Alegre, José and Castro-Marrero, Jesús},
title = {Reduced heart rate variability predicts fatigue severity in individuals with chronic fatigue syndrome/myalgic encephalomyelitis.},
journal = {Journal of translational medicine},
year = {2020},
doi = {10.1186/s12967-019-02184-z},
note = {PubMed: 31906988},
url = {https://www.mecfsatlas.com/evidence/escorihuela-2020-reduced-heart},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/escorihuela-2020-reduced-heart
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