Habek Mario, Pucić Dunja, Mutak Tomislav, Crnošija Luka, Lovrić Mila, Krbot Skorić Magdalena
Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, HR-10000, Zagreb, Croatia.
School of Medicine, University of Zagreb, Zagreb, Croatia.
Neurol Sci. 2020 Nov;41(11):3157-3164. doi: 10.1007/s10072-020-04432-3. Epub 2020 Apr 29.
To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and to investigate the effect of baseline BRSa indices on blood pressure values after 2 years in people with multiple sclerosis (pwMS).
The following data were analysed at baseline and after 2 years: BRSa measured with BRSa1, α-BRSa and β-BRSa, supine and tilted levels of epinephrine and norepinephrine, supine and tilted systolic and diastolic blood pressure levels.
Compared to baseline values, there was no change in α-BRSa (6.96 ± 2.56 vs. 6.64 ± 2.24, p = 0.379) at month 24. α-BRSa at month 24 positively correlated with tilted levels of norepinephrine at month 24 (r = 0.357, p = 0.005). Univariable linear regression analysis revealed that α-BRSa at baseline predicts the value of tilted systolic and diastolic blood pressure at month 24 (B = 2.724, 95% CI 1.357-4.091, p < 0.001 and B = 1.489, 95% CI 0.459-2.519, p = 0.005).
This study provides further evidence for possible role of α-BRSa as a marker of adrenergic hyperactivity in pwMS. These results may explain increased risk for cardiovascular diseases in pwMS.
评估多发性硬化症患者在2年随访期间肾上腺素能压力反射敏感性（BRSa）的变化，并研究基线BRSa指标对2年后血压值的影响。
在基线和2年后分析以下数据：用BRSa1、α-BRSa和β-BRSa测量的BRSa、肾上腺素和去甲肾上腺素的仰卧位和倾斜位水平、仰卧位和倾斜位收缩压和舒张压水平。
与基线值相比，在第24个月时α-BRSa无变化（6.96±2.56 vs. 6.64±2.24，p = 0.379）。第24个月时的α-BRSa与第24个月时去甲肾上腺素的倾斜位水平呈正相关（r = 0.357，p = 0.005）。单变量线性回归分析显示，基线时的α-BRSa可预测第24个月时倾斜位收缩压和舒张压的值（B = 2.724，95%CI 1.357 - 4.091，p < 0.001；B = 1.489，95%CI 0.459 - 2.519，p = 0.005）。
本研究为α-BRSa作为多发性硬化症患者肾上腺素能活动亢进标志物的可能作用提供了进一步证据。这些结果可能解释了多发性硬化症患者心血管疾病风险增加的原因。
