Zahoor Insha, Pan Guodong, Cerghet Mirela, Elbayoumi Tamer, Mao-Draayer Yang, Giri Shailendra, Palaniyandi Suresh Selvaraj
Department of Neurology, Henry Ford Health, Detroit, MI, USA.
Division of Hypertension and Vascular Research, Department of Internal Medicine, Henry Ford Health, Detroit, MI, USA.
Heliyon. 2024 Aug 3;10(15):e35753. doi: 10.1016/j.heliyon.2024.e35753. eCollection 2024 Aug 15.
Autoimmune diseases, including multiple sclerosis (MS), are proven to increase the likelihood of developing cardiovascular disease (CVD) due to a robust systemic immune response and inflammation. MS can lead to cardiovascular abnormalities that are related to autonomic nervous system dysfunction by causing inflammatory lesions surrounding tracts of the autonomic nervous system in the brain and spinal cord. CVD in MS patients can affect an already damaged brain, thus worsening the disease course by causing brain atrophy and white matter disease. Currently, the true prevalence of cardiovascular dysfunction and associated death rates in patients with MS are mostly unknown and inconsistent. Treating vascular risk factors is recommended to improve the management of this disease. This review provides an updated summary of CVD prevalence in patients with MS, emphasizing the need for more preclinical studies using animal models to understand the pathogenesis of MS better. However, no distinct studies exist that explore the temporal effects and etiopathogenesis of immune/inflammatory cells on cardiac damage and dysfunction associated with MS, particularly in the cardiac myocardium. To this end, a thorough investigation into the clinical presentation and underlying mechanisms of CVD must be conducted in patients with MS and preclinical animal models. Additionally, clinicians should monitor for cardiovascular complications while prescribing medications to MS patients, as some MS drugs cause severe CVD.
自身免疫性疾病，包括多发性硬化症（MS），由于强烈的全身免疫反应和炎症，已被证实会增加患心血管疾病（CVD）的可能性。MS可导致心血管异常，这与自主神经系统功能障碍有关，因为它会在大脑和脊髓中自主神经系统的神经束周围引起炎性病变。MS患者的CVD会影响本已受损的大脑，从而通过导致脑萎缩和白质疾病使病程恶化。目前，MS患者心血管功能障碍的真实患病率和相关死亡率大多未知且不一致。建议治疗血管危险因素以改善这种疾病的管理。本综述提供了MS患者CVD患病率的最新总结，强调需要更多使用动物模型的临床前研究来更好地理解MS的发病机制。然而，目前尚无明确的研究探讨免疫/炎症细胞对与MS相关的心脏损伤和功能障碍的时间效应和病因，特别是在心肌方面。为此，必须对MS患者和临床前动物模型的CVD临床表现和潜在机制进行深入研究。此外，临床医生在给MS患者开药时应监测心血管并发症，因为一些MS药物会导致严重的CVD。
