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dc.contributor.authorMikkola, Alma
dc.contributor.authorOjanen, Aku
dc.contributor.authorHartikainen, Juha EK
dc.contributor.authorRemes, Anne M
dc.contributor.authorSimula, Sakari
dc.date.accessioned2018-04-25T11:38:41Z
dc.date.available2018-04-25T11:38:41Z
dc.date.issued2018
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/6552
dc.description.abstractBackground Cardiac repolarization is modulated by the autonomic nervous system. Even though multiple sclerosis associates with prolonged cardiac repolarization the physiology responsible for the phenomenon remains unknown. Objective To study in longitudinal setting whether the patients with confirmed benign and disabling outcome of relapsing-remitting multiple sclerosis (RRMS) differ in regard to changes of cardiac repolarization. Methods Total of 43 patients, 26% with benign (EDSS ≤2 at least 10y after onset symptom) and 74% with disabling (EDSS >2 at least 10y after onset symptom) RRMS, having 12-lead electrocardiogram (ECG) recorded at the time of onset symptom (ECG1) and for follow-up (ECG2), were studied. Heart rate (HR) corrected QT intervals (QTc) reflecting cardiac repolarization were assessed. Results The time interval between ECG1 and ECG2 showed no statistical difference between benign (7.8 ± 4.8y) and disabling (10.2 ± 5.6y; p = .211) RRMS. Patients with benign and disabling RRMS showed similar values of HR (66±9 bpm vs 73 ± 15 bpm; p=.146) and QTc (403 ± 13 ms vs 408 ± 19 ms; p = .450) at the time of ECG1. However, at the time of ECG2, HR was higher (79 ± 14 bpm vs 65 ± 10 bpm; p = .004) and QTc was longer (420 ± 24 ms vs 400 ± 15 ms; p = .012) in patients with disabling than benign RRMS. Correspondingly, HR increased (p = .063) and QTc prolonged (p = .014) during the disease course only in patients with disabling RRMS. Conclusions Deterioration of cardiac autonomic regulation during the disease course associates with disabling but not with benign RRMS. Our findings suggest that assessment of cardiac autonomic regulation should be included in the evaluation of RRMS disease course. In addition, patients with disabling RRMS might be prone to unfavorable cardiovascular outcome also due to deterioration of autonomic nervous system.
dc.language.isoEN
dc.publisherElsevier BV
dc.relation.ispartofseriesMultiple Sclerosis
dc.relation.urihttp://dx.doi.org/10.1016/j.msard.2018.01.029
dc.subjectrelapsing-remitting multiple sclerosis
dc.subjectRRMS
dc.subjectcardiac repolarization
dc.subjectQTc
dc.subjectheart rate
dc.subjectautonomic nervous system
dc.titleCardiac repolarization evolves differently during the course of benign and disabling multiple sclerosi
dc.description.versionfinal draft
dc.contributor.departmentSchool of Medicine / Clinical Medicine
uef.solecris.id52724208en
dc.type.publicationTieteelliset aikakauslehtiartikkelit
dc.rights.accessrights© Elsevier B.V.
dc.relation.doi10.1016/j.msard.2018.01.029
dc.description.reviewstatuspeerReviewed
dc.format.pagerange205-209
dc.relation.issn1352-4585
dc.relation.volume20
dc.rights.accesslevelopenAccess
dc.type.okmA1
uef.solecris.openaccessEi


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