Key result
Cardiovascular dysfunction in multiple sclerosis can result from brainstem lesions and disease severity, necessitating careful therapeutic selection to prevent cardiovascular complications.
Clinicians should be aware of cardiovascular dysfunction in MS and the potential cardiotoxicity of MS therapies to prevent complications and sudden death.
BACKGROUND: Multiple sclerosis (MS) can affect cardiovascular function in a variety of ways leading to abnormalities in blood pressure response, heart rate, heart rhythm, left ventricular systolic function, and may cause pulmonary edema or cardiomyopathy. Cardiovascular dysfunction in MS is incompletely understood and likely underrecognized. REVIEW SUMMARY: The clinical presentation and pathophysiology of cardiovascular dysfunction in MS are reviewed, as are the cardiovascular toxicities of MS therapies, fingolimod and mitoxantrone. Cardiovascular dysfunction in MS can be caused by brainstem lesions affecting autonomic pathways in the medulla, overall plaque burden, and clinical severity of the disease. CONCLUSIONS: Cardiovascular abnormalities may be clinical or subclinical, and can lead to sudden death in some cases. Neurologists should be aware of the clinical presentation and pathophysiology of cardiovascular dysfunction in MS so as to ameliorate cardiovascular symptoms, prevent cardiovascular complications, and choose therapeutic agents that do not worsen underlying cardiovascular disease.
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Kaplan et al. (2015) conducted a review in Multiple sclerosis. Cardiovascular dysfunction in multiple sclerosis can result from brainstem lesions and disease severity, necessitating careful therapeutic selection to prevent cardiovascular complications.
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