| Abstract | UVOD I CILJEVI: Istražiti razlike nestandardnih adrenergičkih indeksa osjetljivosti baroreceptora (BRS) između bolesnika s različitim oblicima multiple skleroze (MS) i zdravih ispitanika. ----- METODE: Retrospektivnom analizom uspoređene su krivulje odgovora sistoličkog tlaka na Valsalvin pokus (balansirani autonomni odgovor (BAR), suprimirani autonomni odgovor (SAR) i pojačani autonomni odgovor (AAR)) i indeksi osjetljivosti baroreceptora (α-BRSa i β-BRSa) u bolesnika s klinički izoliranim sindromom (CIS), relapsno remitirajućim oblikom MS-a (RRMS), progresivnim oblicima MS-a (PMS) te zdravih ispitanika. Također, analizirana je povezanost između BRSa1, α-BRSa i β-BRSa indeksa i koncentracije kateholamina u krvi u mirovanju. ----- REZULTATI: Kod bolesnika s MS-om pronađen je viši α-BRSa indeks u usporedbi sa zdravim ispitanicima (p=0,02). Nije pronađena razlika za BRSa1, α-BRSa i β-BRSa između bolesnika s CIS-om, RRMS-om i PMS-om. Također, nije pronađena povezanost između bolesnika s MS-om i zdravih ispitanika i tipa krivulje odgovora sistoličkog tlaka na Valsalvin pokus (χ(2)=4,332, p=0,114). Bolesnici s MS-om koji imaju krivulju odgovora tipa BAR i AAR imaju povišeni sistolički tlak u odnosu na bolesnike koji imaju krivulju odgovora tip SAR. Pronađena je značajna povezanost između α-BRSa indeksa i sistoličkog tlaka u uspravnom položaju za vrijeme tilt-up testa (rp=0,194, p=0,017), α-BRSa indeksa i noradrenalina (rs=0,228, p=0,021) i BRSa1 indeksa i adrenalina (rs=0,226, p=0,040). ----- ZAKLJUČAK: Kod bolesnika s MS-om i zdravih ispitanika postoji razlika u alfa adrenergičkom odgovoru na Valsalvin pokus. Ovi rezultati mogli bi objasniti povezanost adrenergičke hiperaktivnosti kod bolesnika s MS-om i povećanim kardiovaskularnim rizikom. |
| Abstract (english) | BACKGROUND AND OBJECTIVE: To investigate differences in non-standard adrenergic baroreflex sensitivity (BRS) indices in patients with different phenotypes of multiple sclerosis (pwMS) and healthy controls (HC). ----- METHODS: Retrospective analysis of types of systolic blood pressure (BP) curves during Valsalva maneuver (VM) (balanced (BAR), augmented (AAR) and suppressed (SAR) autonomic responses) and adrenergic baroreflex sensitivity measured with BRSa1, α-BRSa and β-BRSa in patients with clinically isolated syndrome (CIS), relapsing remitting multiple sclerosis (RRMS), progressive multiple sclerosis (PMS) and HC was conducted. Correlations between BRSa1, α-BRSa and β-BRSa and resting catecholamines levels were also investigated. ----- RESULTS: PwMS had higher α-BRSa compared to HC (p=0.02). There was no difference in BRSa1, α-BRSa and β-BRSa between patients with CIS, RRMS and PMS. There was no association between pwMS and HC and the type of sBP curve (χ(2)=4.332, p=0.114). PwMS and BAR or AAR had higher supine systolic BP compared to pwMS and SAR. There was a significant correlation between α-BRSa and upright systolic BP during tilt-up test (rp=0.194, p=0.017), α-BRSa and norepinephrine (rs=0.228, p=0.021) and BRSa1 and epinephrine (rs=0.226, p=0.040). ----- CONCLUSION: pwMS and HC exhibit different alpha-adrenergic response to Valsalva maneuver. These results may explain the connection between MS and increased cardiovascular risk. |
