scholarly journals Evidence of Autonomic Dysfunction in Patients with Relapsing-Remitting Multiple Sclerosis: Heart Rate Variability and Cardiovascular Parameters

2021 ◽  
Vol 28 (1) ◽  
pp. 10-19
Author(s):  
Liudmila Gerasimova-Meigal ◽  
Ilya Sirenev ◽  
Alexander Meigal
Keyword(s):  
Multiple Sclerosis ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Frequency Domain ◽  
Autonomic Dysfunction ◽  
Good Health ◽  
Functional Tests ◽  
Relapsing Remitting ◽  
Respiratory Synchronization ◽  
Relapsing Remitting Multiple Sclerosis

This study was aimed at evaluation of autonomic dysfunction in patients with multiple sclerosis (MS) by means of time- and frequency-domain parameters of heart rate variability (HRV) and conventional cardiovascular tests (deep breathing (DB) and active orthostatic test (AOT)). The study group enrolled 32 patients with the relapsing-remitting MS (17 m, 15 f, aged 29 ± 4.9 years, disease duration 4.2 ± 2.7 years, EDSS scores less than 3.0 and 26 subjects in good health (HC, 15 m, 11 f, aged 30.1 ± 2.7 years). In the MS group, at rest the variability of heart rate was decreased in comparison to the HC group seen by time- (SDNN, RMSSD, pNN50, CV, p < 0.01) and frequency-domain (TP, HF, LF, p < 0.05) parameters, what was indicative of the general decrease of the autonomic neurogenic control of the heart rate, both sympathetic and parasympathetic. The functional tests (DB and AOT) showed reduced cardiovascular reactivity in the MS group. Additionally, the cardio-respiratory synchronization was impaired in the MS group at rest and DB. The severity of HRV deficit in the MS group correlated with the activity of MS. In conclusion, the comprehensive assessment of time- and frequency-domain HRV parameters studied with functional tests provides better insight to understanding autonomic dysfunction in subjects with relapsing-remitting MS.

scholarly journals Cardiac Autonomic Dysfunction in Myasthenia Gravis and Relapsing-Remitting Multiple Sclerosis—A Pilot Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2173
Author(s):  
Łukasz Rzepiński ◽  
Monika Zawadka-Kunikowska ◽  
Julia L. Newton ◽  
Paweł Zalewski
Keyword(s):  
Multiple Sclerosis ◽  
Myasthenia Gravis ◽  
Autonomic Dysfunction ◽  
Left Ventricular ◽  
High Frequency Component ◽  
Cardiac Inotropy ◽  
Cardiac Autonomic Dysfunction ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

This study assessed cardiac autonomic response to head-up tilt test (HUTT) in 23 myasthenia gravis (MG) and 23 relapsing-remitting multiple sclerosis (RRMS) patients compared to 30 healthy controls (HC). Task Force® Monitor was used to evaluate cardiac inotropy parameters, baroreflex sensitivity (BRS), heart rate (HRV), and blood pressure variability (BPV) during HUTT. MG patients were characterized by reduced BRS (p < 0.05), post-HUTT decrease in high-frequency component (p < 0.05) and increase in sympathovagal ratio of HRV (p < 0.05) when compared to controls indicating parasympathetic deficiency with a shift of sympathovagal balance toward sympathetic predominance. Compared to HC, MG patients also showed lower cardiac inotropy parameters, specifically, left ventricular work index (LVWI) during supine rest (p < 0.05) as well as LVWI and cardiac index values in response to orthostatic stress (p < 0.01 and p < 0.05, respectively). Compared to controls, RRMS patients were characterized by lower HRV delta power spectral density (p < 0.05) and delta low-frequency HRV (p < 0.05) in response to HUTT suggesting combined sympathetic and parasympathetic dysfunction. There were no differences in cardiac autonomic parameters between MG and MS patients (p > 0.05). Our study highlights the possibility of cardiac and autonomic dysfunction in patients with MG and RRMS which should be considered in the pharmacological and rehabilitation approach to managing these conditions.

Cardiac Autonomic Dysfunction in Relapsing-Remitting Multiple Sclerosis during a Stable Phase

1996 ◽  
Vol 36 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Franco Giubilei ◽  
Agnese Vitale ◽  
Claudia Urani ◽  
Marco Frontoni ◽  
Marina Fiorini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Autonomic Dysfunction ◽  
Stable Phase ◽  
Cardiac Autonomic Dysfunction ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

scholarly journals Chemical Sympathectomy Restores Baroreceptor-Heart Rate Reflex and Heart Rate Variability in Rats With Chronic Nitric Oxide Deficiency

2015 ◽  
pp. 459-466 ◽  
Author(s):  
M. CHASWAL ◽  
S. DAS ◽  
J. PRASAD ◽  
A. KATYAL ◽  
M. FAHIM
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Frequency Domain ◽  
Autonomic Dysfunction ◽  
Sympathetic Innervation ◽  
Chemical Sympathectomy ◽  
Principal Mechanism ◽  
Cardiac Autonomic Dysfunction

Nitric oxide (NO) plays a crucial role not only in regulation of blood pressure but also in maintenance of cardiac autonomic tone and its deficiency induced hypertension is accompanied by cardiac autonomic dysfunction. However, underlying mechanisms are not clearly defined. We hypothesized that sympathetic activation mediates hemodynamic and cardiac autonomic changes consequent to deficient NO synthesis. We used chemical sympathectomy by 6-hydroxydopamine to examine the influence of sympathetic innervation on baroreflex sensitivity (BRS) and heart rate variability (HRV) of chronic NG-nitro-L-arginine methyl ester (L-NAME) treated adult Wistar rats. BRS was determined from heart rate responses to changes in systolic arterial pressure achieved by intravenous administration of phenylephrine and sodium nitroprusside. Time and frequency domain measures of HRV were calculated from 5-min electrocardiogram recordings. Chronic L-NAME administration (50 mg/kg per day for 7 days orally through gavage) in control rats produced significant elevation of blood pressure, tachycardia, attenuation of BRS for bradycardia and tachycardia reflex and fall in time as well as frequency domain parameters of HRV. Sympathectomy completely abolished the pressor as well as tachycardic effect of chronic L-NAME. In addition, BRS and HRV improved after removal of sympathetic influence in chronic L-NAME treated rats. These results support the concept that an exaggerated sympathetic activity is the principal mechanism of chronic L NAME hypertension and associated autonomic dysfunction.

Cardiac Dysrhythmias and Autonomic Dysfunction in Chronic Spinal Cord Injury: A 24-Hour Holter Monitoring and Heart Rate Variability Study

1999 ◽  
Vol 13 (4) ◽  
pp. 235-241 ◽  
Author(s):  
Gülçin Demirel ◽  
Seref Demirel ◽  
Hürriyet Yilmaz ◽  
Vakur Akkaya ◽  
Dursun Atilgan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Heart Rate Variability ◽  
Frequency Domain ◽  
Autonomic Dysfunction ◽  
Time Domain ◽  
Chronic Spinal Cord Injury ◽  
Cardiac Dysrhythmias ◽  
Cord Injury

The purpose of this study is to evaluate chronic spinal cord injury (SCI) patients for the incidence of cardiac dysrhythmias and the level of autonomic nervous system (ANS) dysfunction using 24-hour Holter recordings and long-term time-domain and frequency-domain heart rate variability (HRV) analysis. There was no difference be tween groups for the frequency of ventricular or supraventricular ectopics, minimal and mean heart rate, and the longest RR intervals. Maximum heart rate was lower in the quadriplegic group compared with controls (124.1 ± 11.2 vs. 139.4 ± 10.9, p < 0.05). Frequency-domain spectral analysis of high, low, total frequency powers, and ratio LF/HF showed no significant difference between groups. On time-domain analy sis SDANN (94.5 ± 26.4 vs. 131.1 ± 15.1, p < 0.0 1) and SDNN (110.1 ± 29.2 vs. 143.6 ± 19. 1, p < 0.05) were significantly lower in quadriplegics compared with controls. SDANN (74.0 ± 17.9 vs. 115.0 ± 14.2 p < 0.01) and SDNN ( 90.2 ± 21.1 vs. 130.0 ± 22.0 p < 0.05) were significantly lower in complete quadriplegics com pared with incomplete quadriplegics. When the effect of wake (07-22)-sleep (23-07) cycle on frequency-domain parameters were assessed, HF (12.38 ± 5.1 vs. 21.18 ± 8.05, p = 0.001) and TP (35.93 ± 10.5 vs. 45.68 ± 12.68, p = 0.004) showed the physiologic increase during sleep in controls, but was unchanged in quadriplegics (10.48 ± 5.39 vs. 13.35 ± 8.03, p = 0.205 and 30.67 ± 10.61 vs. 37.01 ± 17.59, p = 0.208, respectively). In paraplegics a blunted increase in HF (14.61 ± 7.69 vs. 19.85 ± 14.13, p = 0.09) and TP (38.5 ± 12.77 vs. 47.13 ± 23.08, p = 0.08) was observed. LF showed no significant change in the three groups. Heart rate circadian rhythm was preserved in all three groups (p < 0.01). We concluded that chronic complete cer vical SCI may disrupt modulatory sympathetic flow and downregulates parasympa thetic activity but causes no major arrhythmias needing treatment. Key Words: Chronic spinal cord injury—Cardiac dysrhythmia—Autonomic dysfunction-Heart rate variability.

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