Key result
Relapsing-remitting multiple sclerosis was associated with significantly reduced heart rate variability parameters, including SDNNI (median 41.0 vs 51.0, p=0.009), indicating parasympathetic autonomic dysfunction compared to healthy controls.
Why the study?
The study aimed to evaluate the presence of cardiovascular autonomic dysfunction using HRT and HRV parameters via 24-h Holter ECG monitoring in patients with relapsing-remitting MS without known heart disease.
Do patients with relapsing-remitting multiple sclerosis have impaired cardiovascular autonomic function compared to healthy controls?
Case-Control (n=48)
No
Do patients with relapsing-remitting multiple sclerosis have impaired cardiovascular autonomic function compared to healthy controls?
Absolute Event Rate: 41% vs 51%
p-value: p=0.009
Patients with relapsing-remitting multiple sclerosis exhibit reduced heart rate variability, indicating cardiovascular autonomic dysfunction involving both parasympathetic and sympathetic systems.
Lower HRV parameters indicate autonomic dysfunction in RRMS; leaves open whether these markers aid risk stratification or require prospective validation.
Background/aim: Multiple sclerosis (MS) is an autoimmune disease characterized by neurodegeneration or demyelination; the relapsing–remitting phase of MS is characterized by acute exacerbation of disease activity. The most commonly used noninvasive approach to assess autonomic function is the determination of heart rate turbulence (HRT) and heart rate variability (HRV). The aim of this study was to evaluate the presence of cardiovascular autonomic dysfunction using HRT and HRV parameters determined via 24-h Holter ECG monitoring in patients with relapsing–remitting MS without known heart disease. Materials and methods: The study included 26 patients diagnosed with relapsing–remitting MS and 22 age- and sex-matched healthy controls. HRT and HRV parameters were analyzed via 24-h Holter ECG monitoring. Magnetic resonance imaging findings were reevaluated to identify any demyelinating lesions in the brain stem. Results: The HRV parameters of SDNNI (mean of the standard deviations of all normal sinus RR intervals in all 5-min segments), rMSSD (root–mean–square successive difference), and sNN50 (percentage of successive normal sinus RR intervals >50 ms) were significantly lower in the MS group than in the control group (P < 0.05). Conclusion: This study revealed that the patients with MS had reduced HRV; this was demonstrated by dysfunction with regard to parasympathetic and sympathetic parameters in HRV analysis.
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Gökaslan et al. (2020) conducted a case-control in Relapsing-remitting multiple sclerosis (n=48). Relapsing-remitting multiple sclerosis vs. Healthy controls was evaluated on SDNNI (mean of the standard deviations of all normal sinus RR intervals for all 5-min segments) (p=0.009). Relapsing-remitting multiple sclerosis was associated with significantly reduced heart rate variability parameters, including SDNNI (median 41.0 vs 51.0, p=0.009), indicating parasympathetic autonomic dysfunction compared to healthy controls.
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