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Progressive impairment of cardiac autonomic balance in patients with multiple sclerosis

Background and aim: The disturbances of autonomic nervous system function have already been described in patients with multiple sclerosis (MS). However, the data about the level of cardiac autonomic dysbalance in MS patients dependent on duration of the disease lacked in relevant literature. The aim of study was to investigate differences in cardiac autonomic balance in the patients with MS dependent on duration of the disease. Patients and methods: This study included 18 patients (12 female and 6 male ; mean age 43 &plusmn ; ; ; 4 years) with MS during a stable phase and 18 age and sex-matched healthy controls. The MS patients divided into two groups: group I - 8 patients within 5 years (mean 3.9 &plusmn ; ; ; 1.1 years) and group II - 10 patients with more than 5 years (mean 7.8 &plusmn ; ; ; 1.6 years) from establishment of diagnosis of MS, respectively. The mean degree of disability of the patients was 3, 0 &plusmn ; ; ; 2, 8 according to the Expanded Disability Status Scale (EDSS). Cardiac autonomic balance was evaluated by analysis of heart rate variability (HRV) from 24-hours Holter ECG (Oxford Instruments). Statistical analysis was performed using the commercial software package, SPSS for Windows, Version 10, 0. The results are expressed as a mean &plusmn ; ; ; standard deviation. Differences between groups were tested using the Kruscall-Wallis test. The value of p<0.05 was considered statistically significant. Results: Patients with MS had significantly lower overall HRV than controls: SDNN 90 &plusmn ; ; ; 23 ms vs. 137 &plusmn ; ; ; 26 ms, p <0.001 ; TP 1912 &plusmn ; ; ; 1222 vs. 3653 &plusmn ; ; ; 1536 ms2 ; p<0.001. The patients from group I had higher all HRV parameters except LF/HF ratio compared with patients from group II: SDNN 94 &plusmn ; ; ; 24 vs. 88 &plusmn ; ; ; 21 ms, p=0.01 ; TP 2031 &plusmn ; ; ; 1328 vs. 1683 &plusmn ; ; ; 1017 ms2, p=0.008. Conclusion: The results of this study suggest that level of cardiac autonomic dysbalance in patients with MS depend on duration of disease. The longer duration of the disease lead to progressive impairment of cardiac autonomic balance in patients with MS.

Cardiac autonomic balance; Heart rate variability; Multiple sclerosis; Disease duration

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