Neurocardiology Update: The Brain-Heart Connection in Multiple Sclerosis-A Narrative Review.

Area of Science:

• Neuroimmunology
• Cardiology
• Neurology

Background:

• Multiple sclerosis (MS) is increasingly recognized as having significant links to cardiovascular diseases (CVDs).
• This association impacts MS disease progression and overall patient prognosis.
• Understanding this link is vital for comprehensive patient care.

Purpose of the Study:

• To raise awareness of the association between MS and CVDs.
• To promote a clinical, multidisciplinary approach for managing MS patients with cardiovascular comorbidities.
• To highlight the long-term benefits of integrated care.

Main Methods:

• A comprehensive literature review was performed.
• Evidence on CVD incidence, mechanisms, and impact on MS was gathered.
• A neurocardiological approach for clinical practice was proposed.

Main Results:

• High rates of hypertension, metabolic syndrome, stroke, and myocardial infarction are common in MS patients.
• Venous thromboembolism and autonomic dysfunction are prevalent but often overlooked comorbidities.
• Cardiovascular dysfunction negatively impacts MS progression, from subclinical impairments to overt disability.
• A complex interplay of genetic, lifestyle, inflammatory, and treatment factors contributes to CVDs in MS.

Conclusions:

• Cardiovascular comorbidities significantly increase mortality in MS patients.
• Cardiovascular pathology adversely affects clinical and radiological outcomes in MS.
• Proactive surveillance and preventative strategies are essential for MS patients with CVDs.