MS Patients Tend to Have More Heart Problems, Need Better Exams, Study Shows

MS Patients Tend to Have More Heart Problems, Need Better Exams, Study Shows

Researchers found that patients with multiple sclerosis (MS) have increased heart problems suggestive of an intrinsic myocardial disease, and would benefit from cardiovascular examinations using more advanced techniques.

The study, “Impaired Cardiac Function in Patients with Multiple Sclerosis by Comparison with Normal Subjects,” was published in the journal Scientific Reports.

An assessment of cardiovascular function in MS patients is rarely performed, and when it is, it usually relies on conventional imaging techniques, such as 2D-echocardiography and tissue Doppler, that might fail to detect subtle changes.

Therefore, it’s important to deepen our knowledge about the types of heart problems and to what extent they occur in MS patients.

A few studies have shown that MS is associated with an increased risk of hospital admission for stroke, heart attack, and heart failure in the first year of diagnosis, suggesting that early diagnosis of cardiovascular impairments might be crucial to start preventive care in these patients.

Now, researchers undertook a comprehensive cardiovascular assessment in patients with MS. They compared several cardiovascular parameters in 67 people with MS and 36 age- and sex-matched healthy control subjects.

Among the MS patients, about half were on interferon or Copaxone (glatiramer acetate) treatment while the rest were newly diagnosed and had no prior immunomodulatory treatment.

Both MS patients and healthy controls had an equal incidence of cardiovascular risk factors, such as arterial hypertension, high lipids in the blood, smoking habits, and obesity.

To improve sensitivity in detecting heart malfunctions, besides using conventional techniques, the team also used new echocardiographic methods such as speckle tracking and real-time 3D-echocardiography.

Through these techniques, researchers found that both the right and left sides of the heart had more impairments in MS patients when compared to healthy people.

Those with MS had a reduced left ventricular systolic (when the heart beats) and diastolic (when the heart rests between beats) function, reduced left atrial function, impaired right ventricular systolic activity, and increased systolic pulmonary artery pressure.

But parameters related to the function of arteries, blood supply to the heart, and heart failure were unchanged in MS patients. 

Also, being on interferon or Copaxone did not seem to make a difference, as the same cardiac impairments were seen in patients under treatment and those who weren’t.

The team suggests that a higher incidence of cardiovascular problems in MS might be due to the presence of mutated muscle proteins, which are also present in the myocardium — the heart’s muscle. Another reason might be the higher frequency of cardiac risk factors in people with MS, such as smoking, high lipid levels in the blood, and lack of exercise.

The study shows that MS patients have increased cardiac impairments linked to intrinsic myocardial disease. The results call attention to the importance of performing a comprehensive cardiovascular exam in people with MS, using more advanced techniques that can help to prevent life-threatening heart failure.

“These findings are significant for the daily clinical practice by emphasizing that this young and active population should receive the best standard of care from a multidisciplinary team, including a cardiologist,” the researchers wrote.

“We suggest the use of the new echocardiographic techniques for the early detection of cardiovascular dysfunction in patients with MS, because they are harmless, inexpensive, and largely available,” the team added.

6 comments

  1. Mark Hill says:

    Thank you Ana, if by inherent you mean congenital, then this is wrong. Medical research needs to speak and write clear English if it wishes to be understood. What EXACTLY does it mean by ‘inherent’. If it means inherited, then, again, it is simply wrong. However, there is no doubt that MS causes high blood pressure which leads to heart disease. Neurologists should have taken serious note of high blood pressure in MS patients years ago. It should also have taken note of the serious side effects of blood pressure pills on MS patients; especially oedema.

    • Ana Pena says:

      Dear Mark, thank you for your comment.

      It is important to note that the authors of the study do not mention inherent, inherited or congenital. The term used is “intrinsic myocardial disease.”
      Intrinsic in this context refers to the fact that the condition results from the heart’s muscle itself (an intrinsic cause) rather than from external causes (extrinsic) to the heart, such as high blood pressure. In fact, researchers did not find increased problems in arterial and endothelial function outside the heart in MS subjects when compared with controls.

      Kind regards,

      Ana Pena

  2. Jill Brown says:

    I have secondary progressive MS and I have recently been diagnosed with unexplained impaired ventricular systolic function, which is to be treated as dilated cardiomyopathy.

    This lead me to think maybe it was caused by the MS which is how I came to read this article. I realise the study was with people much younger than me, I am 66, but it has made me feel better about my diagnosis.

  3. Melissa says:

    My husband passed at age 54 in Jan 2015 of a heart attack. His mother had history of heart disease and he had MS. He had taken Copsxone and was under a neurologist care at Cleveland Clinic and had MRI done just weeks before he passed showing the MS was not progressing at the time. He was a smoker and was 5’7” and 205lbs at time of death. He had no children and unfortunately his sexual desire was none and he couldn’t talk about it. He was the best husband in the world! He was on vacation from work at the time of his death. He had worked at his job since age 18 and didn’t even get to enjoy retirement. I wish I had seen this article before and he had watched his heart more closely!!!!

  4. Eleanor Santo says:

    I am a 59 year old female who was diagnosed with RRMS 17 years ago. About a year ago I noticed that my heart rate was elevated 120-150 for several hours with no reasonable explanation for it. Additionally I was having intermittent episodes of high blood pressure 170-200/90. I have been worked up for Pheochromocytoma and other epi/norepi secreting tumors, Hyperthyroidism and some other endocrine stuff, all negative. I was told that I had an (old?) MI. The EKG didn’t look that impressive but there was a right BBB. Cardiac work up was negative for acute MI and stress test was normal. My symptoms are intermittent acute sinus tachycardia unrelated to activity and orthostatic in nature accompanied by significant hypertension. I am now on beta blockade and my heartrate is generally controlled although I still have breakthrough tachycardia at times. I am also on an ARB and recently started a Ca channel blocker. My blood pressure is better but still not well controlled and have occasional breakthrough of significant hypertension. Do you have any information on a neuroendocrine connection with these symptoms? Been trying to figure this out for over a year now and recently started HRT .

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