Among patients with multiple sclerosis (MS), about 37% have electrocardiography (ECG) alterations, according to study results presented at the 2022 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) held from June 1-4, in National Harbor, Maryland.

Prior studies have found that MS involves changes to cardiac rate, rhythm, and structure following autonomic dysregulation, poor mobility, cardiovascular risk factors, and the use of disease-modifying therapies (DMTs). ECG changes in some studies have indicated an exercise-induced autonomic response. MS may initially present with acute ECG changes, case reports have suggested, or these could be a reaction to intravenous corticosteroids or fingolimod, a sphingosine-1-phosphate receptor modulator known to affect the atrioventricular node, the researchers explained.

In this study, researchers analyzed how ECG patterns relate to different demographic, clinical, and patient-specific characteristics in a large cohort of patients with MS.


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The researchers retrospectively reviewed 500 medical records. Resting ECG findings were included in the study if a cardiologist had verified the readings. Records of patients presenting with acute illnesses, traumas, allergic reactions, coronary artery disease exacerbation, or stress testing were excluded from the study, as were ECG performed through monitoring fingolimod initial treatment or patients using medications known to affect heart rate.

Descriptive analysis was performed in the study. Frequency differences through χ2, Mann-Whitney U, or Kruskal-Wallis tests based on variable type were examined.

Study data comprised that of individuals aged 55.9±12.7 years (75% women, 83% White). A total of 37% of the participants had forms of ECG alterations (33% bradycardia, 25% tachycardia).

Bundle branch blocks (BBBs) were found in 12% of patients with right BBB as the most prevalent.

Structural ECG data was found for 28% of patients; left atrial enlargement was most frequently documented.

Comparisons of DMTs and fingolimod did not show differences.

While older patients tended to have a higher prevalence of structural changes, especially left atrial enlargement with left ventricular hypertrophy, pairwise differences lacked significance after researchers applied Bonferroni corrections.

“Investigating ECG alterations in large MS populations can help in understanding the autonomic dysregulation interplay with other variables observed in MS,” the researchers concluded.

Reference

Dhari Z, Paro A, Huselid R, et al. Prevalence and types of resting electrocardiography findings in persons with multiple sclerosis. Presented at: CMSC 2022 Annual Meeting; June 1-4, 2022; National Harbor, Maryland. Abstract MDC07.