Our pilot studies (PS) show that chronic low blood flow in fibromyalgia (Fibro) is associated with muscle pain, headaches, increased left ventricular muscle collagen (LVMC), and coronary artery stenosis (CAS), suggesting hypoxic injury. A predictive relationship was found by blind correlation between high adrenergic neurovascular tone (ANVT)/duration of illness (T = time in years) and the increase in LVMC and CAS (r = .97, p < .001). Therapy resulting in reduction of ANVT with increased systemic flow (cardiac output [CO]) results in significantly reduced muscle pain, headaches, LVMC, and CAS in our long-term PS. Prospective patients were selected by criteria of the America College of Rheumatology with normal C-reactive protein and LDL < 103, age 16-65 years, 7/1 female/male, with duration of disease at 6 years (group [G]1) and 12 years for G2. Serial measurements were made of systolic blood pressure (SBP), systolic time intervals (STI = ANVT), CO, systemic vascular resistance (SVR), LVend diastolic volume (EDV = cc/m2), LVMC, right (R) CAS, and LAD CAS by our reported methods. Patient symptom levels (SL) were recorded at 1-100 (fatigue + pain). Data measurement at start/end (1/2) was placed into a blind matrix for analysis later. Treatment (Rx) with diltiazem CD 240-360 mg q/day and amitryptiline 10-125 mg q/day resulted in sig* improvement as shown below. Prospective results: group means shown:
Where *sig difference from C at p < .01 by t-test. T1 = duration of illness, T2 = Rx T. Rx of prospective patients paralleled PS findings with sig reduction of SL. Ultrasonic measurements proved that LVMC and CAS sig regressed. LVMC and CAS were predicted by STI levels/Rx T (r = .97, p < .001, R2= 94%). This was accomplished by sig reduction in ANVT and restoration of systemic flow (CO) to the control range over the long-term Rx period. Thus, Fibro is a reversible ischemic systemic ANVT disorder.
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