Naschitz, Jochanan E, Sabo, Edmond, Naschitz, Shaul et al. · Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2002 · DOI
This study tested a new way to diagnose ME/CFS by measuring how the heart and blood vessels respond to a simple tilt test (lying down then standing up). Researchers used mathematical analysis of heart rate patterns and blood flow timing to create a scoring system that could correctly identify ME/CFS patients 70% of the time. The test was safe and well-tolerated by participants.
ME/CFS lacks objective diagnostic biomarkers, making clinical diagnosis challenging and delaying treatment. This work demonstrates that mathematical analysis of cardiovascular response patterns during tilt testing could provide objective criteria to support diagnosis, potentially reducing diagnostic delays and improving care access for patients with ME/CFS.
This study does not prove the identified biomarkers cause ME/CFS or explain the underlying mechanism of autonomic dysfunction. The cross-sectional design cannot establish whether cardiovascular abnormalities precede or result from ME/CFS. Validation in a larger, independent cohort is needed before clinical implementation.
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, Jochanan E, Sabo, Edmond, Naschitz, Shaul, Rosner, Itzhak, Rozenbaum, Michael, Priselac, Renata Musafia, et al. (2002). Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome.. Clinical autonomic research : official journal of the Clinical Autonomic Research Society. https://doi.org/10.1007/s10286-002-0044-8
BibTeX
@article{mecfsatlas-naschitz-2002-fractal-analysis,
author = {Naschitz, Jochanan E and Sabo, Edmond and Naschitz, Shaul and Rosner, Itzhak and Rozenbaum, Michael and Priselac, Renata Musafia and Gaitini, Luis and Zukerman, Eli and Yeshurun, Daniel},
title = {Fractal analysis and recurrence quantification analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome.},
journal = {Clinical autonomic research : official journal of the Clinical Autonomic Research Society},
year = {2002},
doi = {10.1007/s10286-002-0044-8},
note = {PubMed: 12357280},
url = {https://www.mecfsatlas.com/evidence/naschitz-2002-fractal-analysis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/naschitz-2002-fractal-analysis
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