van Campen, C Linda M C, Verheugt, Freek W A, Rowe, Peter C et al. · IBRO neuroscience reports · 2023 · DOI
This study looked at how ME/CFS patients' hearts respond when they stand up or tilt upright during a medical test. Normally, when you stand, your heart rate increases to maintain blood flow to your brain. Researchers found that many ME/CFS patients had an incomplete heart rate increase despite their blood flow dropping significantly—a condition called chronotropic incompetence. This problem was more common in patients with more severe ME/CFS.
This is the first study to formally describe orthostatic chronotropic incompetence in ME/CFS, providing a potential mechanism explaining why many patients experience orthostatic intolerance without classic POTS or hypotension. Understanding this heart rate compensation failure may help explain fatigue and symptom exacerbation with positional changes, and could inform future diagnostic criteria and treatment strategies for ME/CFS patients.
This study does not prove that chronotropic incompetence causes ME/CFS symptoms or that it is the primary pathophysiological mechanism of the disease. It also cannot establish whether this finding is specific to ME/CFS or occurs in other conditions, as no other patient populations were studied for comparison. The cross-sectional design prevents determination of whether chronotropic incompetence develops over time or is present from disease onset.
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
van Campen, C Linda M C, Verheugt, Freek W A, Rowe, Peter C, & Visser, Frans C (2023). Orthostatic chronotropic incompetence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).. IBRO neuroscience reports. https://doi.org/10.1016/j.ibneur.2023.04.005
BibTeX
@article{mecfsatlas-van-campen-2023-orthostatic-chronotropic,
author = {van Campen, C Linda M C and Verheugt, Freek W A and Rowe, Peter C and Visser, Frans C},
title = {Orthostatic chronotropic incompetence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).},
journal = {IBRO neuroscience reports},
year = {2023},
doi = {10.1016/j.ibneur.2023.04.005},
note = {PubMed: 37303862},
url = {https://www.mecfsatlas.com/evidence/van-campen-2023-orthostatic-chronotropic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/van-campen-2023-orthostatic-chronotropic
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