Abstract | Cilj je bio istražiti razlike u varijabilnosti sistoličkog krvnog tlaka (SBPV) mjerenog otkucaj po otkucaj kod osoba sa sekundarno progresivnom multiplom sklerozom (SPMS), klinički izoliranim sindromom (CIS) i zdravim kontrolama (HC). Ova retrospektivna studija slučajeva i kontrola uključivala je 46 osoba sa SPMS, 46 sa CIS i 44 HC. Za procjenu SBPV-a korišten je poluautomatizirani softver izrađen u MATLAB-u R2019b (The MathWorks, Inc.). Promatrane su karakteristike u frekvencijskom području: spektar snage u područjima niske frekvencije (LF) i visoke frekvencije (HF) te omjer LF/HF. Podaci su izraženi u apsolutnoj snazi (mmHg2) LF i HF spektra te omjeru (LF/HF) tijekom faza ispitivanja u ležećem položaju i tilt-up table testa. Studija je pokazala da nije bilo značajnih razlika u prosječnim vrijednostima sistoličkog (sBP) ili dijastoličkog krvnog tlaka (dBP) tijekom faza ispitivanja u ležećem položaju i tilt-up table testu između skupina. Tijekom faze ispitivanja u ležećem položaju, LF i LF/HF su značajno niži u grupi SPMS (4,17±5,38 i 3,52±2,34, redom) u usporedbi s CIS-om (5,42±3,59, p=0,015 i 5,92±4,63, p=0,029, redom) i HC grupom (6,03±4,55, p=0,011 i 6,52±5,09, p=0,010, redom), dok je tijekom faze ispitivanja u tilt-up table testu snaga LF značajno niža u usporedbi s obje skupine CIS i HC, a snaga HF je značajno niža samo u usporedbi s grupom CIS. Zaključno, SBPV je izmijenjen kod osoba sa SPMS-om u usporedbi s CIS i normalnim kontrolama. Daljnja istraživanja u području disautonomije povezane s multiplom sklerozom (MS) su opravdana ne samo zbog njihove važnosti vezane uz komorbiditete i simptome MS-a, već i zbog vjerojatne uloge u patofiziologiji MS-a. |
Abstract (english) | Objective was to investigate differences in beat-to-beat systolic blood pressure variability (SBPV) in people with secondary progressive multiple sclerosis (SPMS), clinically isolated syndrome (CIS) and healthy controls (HC). This retrospective, case-control study included 46 people with SPMS, 46 CIS and 44 HC. A semi-automated software made with MATLAB R2019b (The MathWorks, Inc.) was used for evaluation of SBPV. The frequency domain characteristics observed were the power spectrum in the low frequency (LF) and high frequency (HF) bands and the LF/HF ratio. Data is expressed in absolute power (mmHg2) of LF and HF and ratio (LF/HF) during both supine and tilt-up phases of testing. Study showed that there were no significant differences in mean systolic (sBP) or diastolic blood pressure (dBP) values during supine and tilt-up phases of testing between groups. During the supine phase of testing LF and LF/HF were significantly lower in SPMS group (4.17±5.38 and 3.52±2.34, respectively) compared to CIS (5.42±3.59, p=0.015 and 5.92±4.63, p=0.029, respectively) and HC group (6.03±4.55, p=0.011 and 6.52 ±5.09, p=0.010, respectively), while during tilt-up phase LF was significantly lower compared to both CIS and HC group, and HF was significantly lower only compared to CIS group. In conclusion SBPV is altered in people with SPMS compared to CIS and normal controls. Further research in the field of multiple sclerosis (MS) related dysautonomia is warranted not only because of its relevance to comorbidities and MS symptoms, but also because of its likely involvement in the pathophysiology of MS. |