van Campen, C Linda M C, Visser, Frans C · Journal of clinical medicine · 2025 · DOI
When people with ME/CFS and POTS stand up, their blood pressure and heart rate don't respond normally, causing symptoms like dizziness and fatigue. This study looked at 260 ME/CFS patients during a tilt test to understand how the heart's output of blood relates to blood flow in the brain. The researchers found two different patterns: about two-thirds of patients showed their brain blood flow dropped at roughly the same rate as their heart's output decreased, while about one-third had a different pattern where their heart was racing but their heart output wasn't dropping as much, and their brain blood flow didn't follow the expected pattern.
Understanding why some ME/CFS patients with POTS don't maintain adequate brain blood flow during position changes is crucial for explaining orthostatic symptoms and could guide personalized treatment approaches. The identification of two distinct hemodynamic patterns suggests that ME/CFS with POTS may not be a single disease mechanism, potentially explaining why treatments work differently for different patients.
This study does not prove causation—it only describes associations observed during tilt testing. The cross-sectional design cannot determine whether the hyperadrenergic pattern is a primary cause or a compensatory response to another underlying problem. It also does not establish which hemodynamic pattern is more harmful or whether either pattern responds better to specific treatments.
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 & Visser, Frans C (2025). The Relation Between Cardiac Output and Cerebral Blood Flow in ME/CFS Patients with a POTS Response During a Tilt Test.. Journal of clinical medicine. https://doi.org/10.3390/jcm14113648
BibTeX
@article{mecfsatlas-van-campen-2025-relation-between,
author = {van Campen, C Linda M C and Visser, Frans C},
title = {The Relation Between Cardiac Output and Cerebral Blood Flow in ME/CFS Patients with a POTS Response During a Tilt Test.},
journal = {Journal of clinical medicine},
year = {2025},
doi = {10.3390/jcm14113648},
note = {PubMed: 40507411},
url = {https://www.mecfsatlas.com/evidence/van-campen-2025-relation-between},
}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-2025-relation-between
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