Jiahui Tang (China)
Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology NeurologyAuthor Of 1 Presentation
DECREASED CARDIAC AUTONOMIC ACTIVITY AND INCREASED SYMPATHETIC VASCULAR CONTROL IN ADVANCED STAGES OF AMYOTROPHIC LATERAL SCLEROSIS
- Zehui Li (China)
Abstract
Background and Aims:
To explore the changes in cardiovascular autonomic function in patients with amyotrophic lateral sclerosis (ALS) during disease progression.
Methods:
Heart rate and systolic and diastolic blood pressure (SBP, DBP) were continuously recorded 24 hours and compound autonomic symptom score (COMPASS31) was performed for 26 ALS patients and 26 controls. Heart rate variability parameters including SDNN, SDANN, RMSSD, and pNN50 were calculated. Disease severity was evaluated by ALS Functional Rating Scale-Revised (ALSFRS-R) score and King's clinical staging system (early-ALS-Group: King's stage 1 [1 patient] and stage 2 [12 patient]; late-ALS-Group: King's stage 3 [9 patients] and stage 4 [4 patients]).
Results:
No differences were found in age, gender ratio, heart rate, SBP, RMSSD, pNN50 and COMPASS31 score among the three groups. In the late-ALS-Group, SDNN (105.00±21.68ms) and SDANN (91.77±21.26ms) were lower than the early-ALS-Group (SDNN: 134.31±26.11ms, p=0.002; SDANN: 116.46±29.38ms, p=0.014) and controls (SDNN: 130.15±22.46ms, p=0.002; SDANN: 116.46±23.94ms, p=0.005), while in the late-ALS-Group diastolic blood pressure in both day time (day-DBP, 77.2±5.8mmHg) and night time (night-DBP, 76.6±5.7mmHg) were higher than the early-ALS-Group (day-DBP: 71.3±5.1mmHg, p=0.041; night-DBP: 72.8±4.9mmHg, p=0.037) and controls (day-DBP: 70.6±7.2mmHg, p=0.022; night-DBP: 71.9±7.5mmHg, p=0.036). ALSFRS-R score was positively correlated with SDNN (ρ=0.633, p=0.008) and SDANN (ρ=0.610, p=0.012) in ALS patients.
Conclusions:
In the early stages of ALS, patients had similar cardiac autonomic activity and sympathetic vascular control compared with controls. Notably, cardiac autonomic activity decreased and sympathetic vascular control increased in advanced stages of ALS without significant autonomic symptoms.