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Assessment of cardiovascular autonomic dysfunction in multiple system atrophy
1Third Department of Internal Medicine, Hiroshima University School of Medicine, Japan. shihori@hiroshima-u.ac.jp
Summary
Patients with multiple system atrophy (MSA) exhibit cardiovascular autonomic dysfunction, including abnormal blood pressure and heart rate rhythms. This dysfunction, marked by reduced sympathetic and parasympathetic activity, suggests a poorer prognosis for MSA patients.
Area of Science:
- Neurology
- Cardiology
- Autonomic Neuroscience
Background:
- Cardiovascular autonomic dysfunction is linked to prognosis in multiple system atrophy (MSA).
- Understanding these dysfunctions is crucial for managing MSA patients.
Purpose of the Study:
- To investigate cardiovascular autonomic dysfunctions in MSA patients.
- To analyze the relationship between blood pressure (BP) and pulse rate (PR) and heart rate variability (HRV) during the disease's progression.
Main Methods:
- Studied seven MSA patients and seven healthy controls using 24-hour ambulatory BP and heart rate monitoring.
- Assessed BP and PR variations, BP-PR correlation, and heart rate variability (HRV) using power spectral analysis.
- Analyzed the number of changes in successive R-R intervals greater than 50 msec (RR50) and HRV frequency components.
Main Results:
- MSA patients displayed abnormal circadian BP and PR variations and a decreased BP-PR correlation.
- Significant reductions and altered circadian patterns were observed in RR50 and HRV frequency components (high- and low-frequency).
- A negative correlation was found between illness duration and RR50, indicating worsening parasympathetic modulation over time.
Conclusions:
- MSA is characterized by decreased sympathetic and parasympathetic activity and abnormal circadian rhythms of BP and HRV.
- Impaired autonomic balance and worsening parasympathetic function correlate with disease progression.
- These autonomic dysfunctions likely impact cardiovascular health and indicate a poor prognosis in MSA. HRV and BP circadian rhythm analysis are valuable for assessing cardiac autonomic function in MSA.