Sandvik, Miriam Kristine, Sørland, Kari, Leirgul, Elisabeth et al. · PloS one · 2023 · DOI
This study found that people with ME/CFS have problems with how their blood vessels function—both the larger vessels and the smaller ones that deliver oxygen throughout the body. Researchers measured blood vessel response in 39 ME/CFS patients and compared them to healthy people, and found significant differences. Interestingly, when patients were treated over 18 months, their smaller blood vessel function improved slightly, though the larger blood vessels did not change.
This is one of the few studies systematically measuring both large and small blood vessel function in ME/CFS, providing objective evidence that vascular dysfunction may be a biological feature of the disease. Understanding vascular abnormalities could help explain why ME/CFS patients experience fatigue, exercise intolerance, and post-exertional malaise, and may open new treatment pathways.
This study does not prove that vascular dysfunction causes ME/CFS symptoms—it only shows an association. The lack of correlation between FMD and PORH suggests these may reflect different physiological mechanisms, and it remains unclear which vascular changes are primary drivers of symptoms. The study also cannot determine why rituximab did not improve vascular function despite symptom improvement.
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
Sandvik, Miriam Kristine, Sørland, Kari, Leirgul, Elisabeth, Rekeland, Ingrid Gurvin, Stavland, Christina Særsten, Mella, Olav, et al. (2023). Endothelial dysfunction in ME/CFS patients.. PloS one. https://doi.org/10.1371/journal.pone.0280942
BibTeX
@article{mecfsatlas-sandvik-2023-endothelial-dysfunction,
author = {Sandvik, Miriam Kristine and Sørland, Kari and Leirgul, Elisabeth and Rekeland, Ingrid Gurvin and Stavland, Christina Særsten and Mella, Olav and Fluge, Øystein},
title = {Endothelial dysfunction in ME/CFS patients.},
journal = {PloS one},
year = {2023},
doi = {10.1371/journal.pone.0280942},
note = {PubMed: 36730360},
url = {https://www.mecfsatlas.com/evidence/sandvik-2023-endothelial-dysfunction},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/sandvik-2023-endothelial-dysfunction
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