Naschitz, J E, Sabo, E, Naschitz, S et al. · Seminars in arthritis and rheumatism · 2001 · DOI
This study tested how the body's blood pressure and heart rate respond when patients stand up from lying down (a tilt test). Researchers found that people with ME/CFS have much more unstable cardiovascular responses compared to healthy people and those with other conditions. A mathematical score called the hemodynamic instability score (HIS) could correctly identify ME/CFS patients 97% of the time, suggesting this test might help doctors diagnose the condition.
ME/CFS lacks objective diagnostic biomarkers, making diagnosis difficult and delayed. This study suggests that hemodynamic instability during postural challenge could serve as an objective, quantifiable marker to support ME/CFS diagnosis and may help differentiate it from other conditions, potentially improving clinical recognition and reducing diagnostic uncertainty.
This study does not prove that hemodynamic instability causes ME/CFS or explains the underlying disease mechanism. The cross-sectional design cannot establish whether this instability develops before symptom onset or results from the disease itself. Additionally, the failure to distinguish ME/CFS from generalized anxiety disorder suggests the test may not be specific enough for independent clinical use.
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
Naschitz, J E, Sabo, E, Naschitz, S, Shaviv, N, Rosner, I, Rozenbaum, M, et al. (2001). Hemodynamic instability in chronic fatigue syndrome: indices and diagnostic significance.. Seminars in arthritis and rheumatism. https://doi.org/10.1053/sarh.2001.27738
BibTeX
@article{mecfsatlas-naschitz-2001-hemodynamic-instability,
author = {Naschitz, J E and Sabo, E and Naschitz, S and Shaviv, N and Rosner, I and Rozenbaum, M and Gaitini, L and Ahdoot, A and Ahdoot, M and Priselac, R M and Eldar, S and Zukerman, E and Yeshurun, D},
title = {Hemodynamic instability in chronic fatigue syndrome: indices and diagnostic significance.},
journal = {Seminars in arthritis and rheumatism},
year = {2001},
doi = {10.1053/sarh.2001.27738},
note = {PubMed: 11740800},
url = {https://www.mecfsatlas.com/evidence/naschitz-2001-hemodynamic-instability},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/naschitz-2001-hemodynamic-instability
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