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.