9adb283aee760cb4b592a2ac3c887ddf pmc_34071326.pdf 3fdc2d6b9ac62067eede6daa76951a578d2bbfb6 pmc_34071326.pdf ae86016b77ba558f39dbce528d8a0992d11f12ddf884853b86793b6979da556b pmc_34071326.pdf Title: Analysis of Gender Differences in HRV of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Using Mobile-Health Technology Subject: In a previous study using mobile-health technology (mHealth), we reported a robust association between chronic fatigue symptoms and heart rate variability (HRV) in female patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study explores HRV analysis as an objective, non-invasive and easy-to-apply marker of ME/CFS using mHealth technology, and evaluates differential gender effects on HRV and ME/CFS core symptoms. In our methodology, participants included 77 ME/CFS patients (32 men and 45 women) and 44 age-matched healthy controls (19 men and 25 women), all self-reporting subjective scores for fatigue, sleep quality, anxiety, and depression, and neurovegetative symptoms of autonomic dysfunction. The inter-beat cardiac intervals are continuously monitored/recorded over three 5-min periods, and HRV is analyzed using a custom-made application (iOS) on a mobile device connected via Bluetooth to a wearable cardiac chest band. Male ME/CFS patients show increased scores compared with control men in all symptoms and scores of fatigue, and autonomic dysfunction, as with women in the first study. No differences in any HRV parameter appear between male ME/CFS patients and controls, in contrast to our findings in women. However, we have found negative correlations of ME/CFS symptomatology with cardiac variability (SDNN, RMSSD, pNN50, LF) in men. We have also found a significant relationship between fatigue symptomatology and HRV parameters in ME/CFS patients, but not in healthy control men. Gender effects appear in HF, LF/HF, and HFnu HRV parameters. A MANOVA analysis shows differential gender effects depending on the experimental condition in autonomic dysfunction symptoms and HF and HFnu HRV parameters. A decreased HRV pattern in ME/CFS women compared to ME/CFS men may reflect a sex-related cardiac autonomic dysfunction in ME/CFS illness that could be used as a predictive marker of disease progression. In conclusion, we show that HRV analysis using mHealth technology is an objective, non-invasive tool that can be useful for clinical prediction of fatigue severity, especially in women with ME/CFS. Keywords: mHealth; heart rate variability; HRV; ME/CFS; myalgic encephalomyelitis; chronic fatigue syndrome; gender differences Author: Lluis Capdevila, Jesús Castro-Marrero, José Alegre, Juan Ramos-Castro and Rosa M Escorihuela Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri May 28 11:42:14 2021 CEST ModDate: Fri May 28 11:42:14 2021 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1484981 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UWSJPK+URWPalladioL-Ital Type 1 Custom yes yes no 166 0 RXJGZR+URWPalladioL-Bold Type 1 Custom yes yes no 167 0 MQFYIK+VnURWPalladioL-Bold Type 1 Custom yes yes no 168 0 LARSBV+URWPalladioL-Roma Type 1 Custom yes yes no 169 0 OHKNFJ+VnURWPalladioL Type 1 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yes 483 0 JLEMOM+ArialMT CID TrueType Identity-H yes yes yes 484 0 JLECKD+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 485 0 JLECLE+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 486 0 JLECME+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 487 0 JLECMF+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 488 0 JLECMG+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 489 0 JLELMC+Arial-BoldMT CID TrueType Identity-H yes yes yes 490 0 CRUZTT+VnURWPalladioL-Italic Type 1 Custom yes yes no 650 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:15:18 CEST RepresentationInformation: pmc_34071326.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:14:04 CEST Size: 1484981 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 0 FreeObjects: 3 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false 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384, 330, 422, 341 Annotation: Subtype: Link Rect: 346, 295, 383, 306 Annotation: Subtype: Link Rect: 366, 272, 403, 283 Annotation: Subtype: Link Rect: 248, 250, 286, 260 Annotation: Subtype: Link Rect: 226, 226, 263, 237 Annotation: Subtype: Link Rect: 95, 204, 133, 214 Annotation: Subtype: Link Rect: 309, 180, 346, 191 Annotation: Subtype: Link Rect: 520, 169, 557, 180 Annotation: Subtype: Link Rect: 254, 146, 291, 157 Annotation: Subtype: Link Rect: 316, 123, 353, 134 Annotation: Subtype: Link Rect: 520, 111, 557, 122 Annotation: Subtype: Link Rect: 294, 88, 331, 99 Page: Sequence: 19 Annotations: Annotation: Subtype: Link Rect: 191, 710, 229, 720 Annotation: Subtype: Link Rect: 400, 686, 436, 699 Annotation: Subtype: Link Rect: 429, 663, 466, 674 Annotation: Subtype: Link Rect: 418, 640, 455, 651 Annotation: Subtype: Link Rect: 100, 618, 137, 628 Annotation: Subtype: Link Rect: 144, 618, 180, 628 Annotation: Subtype: Link Rect: 59, 584, 97, 594 Annotation: Subtype: Link Rect: 103, 584, 139, 594 Annotation: Subtype: Link Rect: 254, 560, 292, 571 Annotation: Subtype: Link Rect: 298, 560, 334, 571 Annotation: Subtype: Link Rect: 59, 538, 97, 548 Annotation: Subtype: Link Rect: 251, 514, 289, 525 Annotation: Subtype: Link Rect: 519, 502, 557, 513 Annotation: Subtype: Link Rect: 364, 479, 401, 490 Annotation: Subtype: Link Rect: 295, 445, 333, 456 Annotation: Subtype: Link Rect: 289, 410, 326, 421 Annotation: Subtype: Link Rect: 305, 376, 342, 387 Annotation: Subtype: Link Rect: 267, 341, 304, 352 Annotation: Subtype: Link Rect: 311, 341, 347, 352 Annotation: Subtype: Link Rect: 122, 308, 160, 318 Annotation: Subtype: Link Rect: 166, 308, 202, 318 Annotation: Subtype: Link Rect: 371, 284, 409, 295 Annotation: Subtype: Link Rect: 415, 284, 451, 295 Annotation: Subtype: Link Rect: 232, 249, 270, 260 Annotation: Subtype: Link Rect: 276, 249, 312, 260 Annotation: Subtype: Link Rect: 501, 226, 538, 237 Checksum: 784c9e34 Type: CRC32 Checksum: 9adb283aee760cb4b592a2ac3c887ddf Type: MD5 Checksum: 3fdc2d6b9ac62067eede6daa76951a578d2bbfb6 Type: SHA-1 Checksum: ae86016b77ba558f39dbce528d8a0992d11f12ddf884853b86793b6979da556b Type: SHA-256