Journal of IiMER May 2025 At BRMEC14, Professor Cochemé will discuss how redox signalling and oxidative stress contribute to ageing and chronic disease, drawing important connections to ME/CFS and Long COVID. Her participation will enrich discussions, bridge basic science and clinical research, and inspire new collaborative efforts to better understand and treat these complex conditions. David Systrom Assistant Professor of Medicine, Brigham and Women's Hospital, Harvard Medical School, USA Dr David Systrom is Assistant Professor of Medicine at Harvard Medical School and a pulmonary and critical care physician at Brigham and Women’s Hospital, where he directs the Dyspnoea Clinic and the Advanced Cardiopulmonary Exercise Testing Program. With over 35 years on the Harvard faculty, he is internationally recognised for his research into exercise intolerance in ME/CFS and related conditions. Dr Systrom’s work focuses on invasive cardiopulmonary exercise testing (iCPET), which measures cardiovascular, respiratory, and metabolic responses during maximal exercise. He has shown that many people with ME/CFS experience impaired cardiac preload, reduced peak cardiac output, and poor systemic oxygen extraction during exercise. These abnormalities reflect neurovascular dysregulation and autonomic dysfunction rather than deconditioning, and his studies indicate that small fibre neuropathy may contribute to these circulatory and metabolic problems. His research helps explain the profound fatigue, post-exertional malaise, and orthostatic intolerance in ME/CFS. He is currently leading a major study using muscle biopsies to investigate skeletal muscle mitochondrial dysfunction in ME/CFS and has completed the first randomised controlled trial of pyridostigmine in ME/CFS, which improved exercise capacity by increasing cardiac output and right ventricular filling pressures. By comparing ME/CFS with long COVID, his work highlights shared mechanisms and supports the development of common treatment approaches. BRMEC14: Metabolic Insights from Invasive Cardiopulmonary Exercise Testing in ME Dr Systrom will present findings from invasive cardiopulmonary exercise testing in ME/CFS, highlighting abnormalities in oxygen delivery and utilisation, and their relationship to exercise intolerance and fatigue. IIMEC17: Neurovascular Dysregulation During Exercise in ME At the Invest in ME Research Conference, Dr Systrom will present on “Neurovascular Dysregulation During Exercise in ME”, sharing insights from his research into how abnormalities in vascular and autonomic function contribute to the hallmark symptoms of ME/CFS. His work supports efforts to better characterise disease mechanisms and identify potential therapeutic targets, in alignment with the aims of Invest in ME Research. Invest in ME Research Page 29 of 43
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