Frontoni M, Fiorini M, Strano S, Cerutti S, Giubilei F, Urani C, Bastianello S, Pozzilli C
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Acta Neurol Scand. 1996 Apr;93(4):241-5. doi: 10.1111/j.1600-0404.1996.tb00514.x.
In multiple sclerosis (MS) autonomic cardiovascular dysfunction is an uncommon, but potentially dangerous event, to which studies of spectral analysis of heart rate variability have not been applied, yet. MATERIAL AND METHODS--We studied 16 patients with definite MS (11 women and 5 men, mean age 30.3 +/- 7.4 yrs., mean EDSS 2.06 +/- 1.42) and 16 sex- and age-matched healthy controls. Besides cardiovascular reflex tests (valsalva manoeuvre, deep breathing, lying to standing, Blood Pressure response to standing and sustained handgrip), each underwent spectral analysis of the R-R interval short-term variability at rest and after tilting, to detect three components: very low frequency (VLF), low frequency (LF) and high frequency (HF). A recent brain MRI was obtained from patients, to compare plaque characteristics with spectral parameters. RESULTS--At cardiovascular reflexes, only four patients (25%) showed an impairment, mostly of a mild degree. VLF and LF at rest were lower in MS subjects than in controls (p < 0.01). No significant correlation was found between spectral parameters and lesion area or localization as detected on MRI. CONCLUSIONS--Spectral analysis could usefully flank reflex tests to detect autonomic subclinical cardiovascular abnormalities.
在多发性硬化症（MS）中，自主心血管功能障碍是一种罕见但可能危险的事件，心率变异性频谱分析研究尚未应用于此。材料与方法——我们研究了16例确诊为MS的患者（11名女性和5名男性，平均年龄30.3±7.4岁，平均扩展残疾状态量表[EDSS]评分2.06±1.42）以及16名年龄和性别匹配的健康对照者。除了进行心血管反射测试（瓦尔萨尔瓦动作、深呼吸、平卧位到站立位、站立位血压反应和持续握力）外，每位受试者还在静息和倾斜后接受了R-R间期短期变异性的频谱分析，以检测三个成分：极低频（VLF）、低频（LF）和高频（HF）。从患者处获取了近期的脑部磁共振成像（MRI），以比较斑块特征与频谱参数。结果——在心血管反射方面，只有4名患者（25%）出现损害，大多为轻度。MS患者静息时的VLF和LF低于对照组（p<0.01）。在MRI上检测到的频谱参数与病变面积或定位之间未发现显著相关性。结论——频谱分析可作为反射测试的有益补充，以检测自主神经亚临床心血管异常。
