Lerner, A M, Lawrie, C, Dworkin, H S · Chest · 1993 · DOI
This study looked at heart activity recorded over 24 hours in ME/CFS patients compared to others. All 24 ME/CFS patients showed unusual patterns on their heart monitors (abnormal T waves), compared to only 22% of people without ME/CFS. Further testing found that 8 out of 60 ME/CFS patients had mild heart pumping problems that only showed up during exercise, even though their resting heart function appeared normal. The researchers suggest ME/CFS fatigue might be related to the heart not working well during normal daily activities.
This early study provides objective evidence of cardiac abnormalities in ME/CFS that are not explained by traditional coronary disease, suggesting the fatigue may have a physiological basis in cardiac function. The finding that heart dysfunction emerges during normal activity levels—not just extreme exertion—is particularly relevant for understanding why ME/CFS patients experience fatigue with everyday tasks.
This study does not prove that cardiac dysfunction causes ME/CFS fatigue, only that it co-occurs in some patients. The observational design and small sample size (24 initial CFS cases, 8 with dysfunction) mean findings may not generalize to all ME/CFS populations. The study cannot determine whether the cardiac abnormalities are primary to the disease or secondary consequences.
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
Lerner, A M, Lawrie, C, & Dworkin, H S (1993). Repetitively negative changing T waves at 24-h electrocardiographic monitors in patients with the chronic fatigue syndrome. Left ventricular dysfunction in a cohort.. Chest. https://doi.org/10.1378/chest.104.5.1417
BibTeX
@article{mecfsatlas-lerner-1993-repetitively-negative,
author = {Lerner, A M and Lawrie, C and Dworkin, H S},
title = {Repetitively negative changing T waves at 24-h electrocardiographic monitors in patients with the chronic fatigue syndrome. Left ventricular dysfunction in a cohort.},
journal = {Chest},
year = {1993},
doi = {10.1378/chest.104.5.1417},
note = {PubMed: 8222798},
url = {https://www.mecfsatlas.com/evidence/lerner-1993-repetitively-negative},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/lerner-1993-repetitively-negative
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