Key result
Relapsing-remitting multiple sclerosis was associated with significantly reduced heart rate variability at rest compared to healthy controls (median SDNN 39 ms vs 51 ms, p<0.01), indicating decreased autonomic neurogenic control.
Why the study?
The study was aimed at evaluating autonomic dysfunction in patients with multiple sclerosis using heart rate variability parameters and conventional cardiovascular tests.
Do patients with relapsing-remitting multiple sclerosis exhibit autonomic dysfunction as measured by heart rate variability compared to healthy controls?
Cross-Sectional (n=54)
No
Do patients with relapsing-remitting multiple sclerosis exhibit autonomic dysfunction as measured by heart rate variability compared to healthy controls?
Absolute Event Rate: 39% vs 51%
p-value: p=<0.01
Patients with relapsing-remitting multiple sclerosis demonstrate significant autonomic dysfunction characterized by reduced heart rate variability and impaired cardiovascular reactivity.
HRV testing detects autonomic dysfunction in mild RRMS; hypothesis-generating and should not yet change practice.
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.
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Gerasimova-Meigal et al. (2021) conducted a cross-sectional in Relapsing-Remitting Multiple Sclerosis (n=54). Relapsing-Remitting Multiple Sclerosis vs. Healthy controls was evaluated on Standard deviation of normal RR intervals (SDNN) at rest (p=<0.01). Relapsing-remitting multiple sclerosis was associated with significantly reduced heart rate variability at rest compared to healthy controls (median SDNN 39 ms vs 51 ms, p<0.01), indicating decreased autonomic neurogenic control.
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