Hilz MJ, Intravooth T, Möller S, Wang R, Lee DH, Koehn J, Linker R (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 10
Pages Range: e0132139
Journal Issue: 7
DOI: 10.1371/journal.pone.0132139
In multiple sclerosis (MS) patients, Fingolimod may induce prolonged heart-rate slowing which might be caused by MS-related central autonomic lesions.To evaluate whether MS-patients with prolonged heart-rate slowing (> six hours) upon Fingolimod show cardiovascular-autonomic dysfunction before Fingolimod-initiation.Before Fingolimod-initiation, we recorded electrocardiographic RR-intervals (RRIs) and blood-pressure (BP) at rest, upon standing-up, during metronomic deep-breathing, Valsalva-maneuver, and "sustained-handgrip-exercise" in 21 patients with relapsing-remitting MS, and 20 healthy persons. We calculated sympathetic and parasympathetic cardiovascular parameters, including low- (LF) and high-frequency (HF) powers of RRI- and BP-oscillations, RRI-RMSSDs, RRI- and BP-changes during handgrip-exercise, parasympathetic heart-rate-slowing in relation to BP-overshoot after Valsalva-strain-release. We compared values of healthy persons and patients with and without prolonged heart-rate slowing after Fingolimod-initiation (ANOVA; significance: p<0.05).Upon Fingolimod-initiation, 7/21 patients had prolonged HR-slowing. Before Fingolimod, these patients had higher resting BP and higher BP increase during handgrip-exercise than had the other participants (p<0.05). They did not reduce parasympathetic HR-parameters upon standing-up. After Valsalva-strain-release, their parasympathetic HR-slowing in response to BP-overshoot was four times higher than in the other participants (p<0.05).The autonomic cardiovascular dysfunction in MS-patients with delayed HR-re-acceleration upon Fingolimod-initiation suggests that MS-related central autonomic lesions compromise HR-re-acceleration upon Fingolimod.German Clinical Trial Register DRKS00004548 http://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do.
APA:
Hilz, M.-J., Intravooth, T., Möller, S., Wang, R., Lee, D.-H., Koehn, J., & Linker, R. (2015). Central Autonomic Dysfunction Delays Recovery of Fingolimod Induced Heart Rate Slowing. PLoS ONE, 10(7), e0132139. https://doi.org/10.1371/journal.pone.0132139
MLA:
Hilz, Max-Josef, et al. "Central Autonomic Dysfunction Delays Recovery of Fingolimod Induced Heart Rate Slowing." PLoS ONE 10.7 (2015): e0132139.
BibTeX: Download