Disautonomía cardíaca parasimpática en pacientes con esclerosis lateral amiotrófica

Abstract

Introduction

Although some studies have shown the presence of cardiac dysautonomia in amyotrophic lateral sclerosis (ALS) patients, its relationship with the disease is still controversial.

Objective

To explore cardiac dysautonomia in ALS and its possible association with disease evolution and patient's quality of life.

Materials and methods

We evaluated demographics and disease-related variables, comorbidities and quality of life in 20 ALS patients. We performed the autonomic symptoms profile and SF-36 (quality of life) scales. Patients were also evaluated with dynamometry, orthostatic testing and RR interval variability (RRIV) in resting and deep breathing electrocardiograms. Twenty age- and gender- matched healthy individuals served as controls for autonomic cardiovascular measurements.

Results

The mean age of ALS patients was 52 ± 14 years, 75% were male and 85% had spinal disease onset. The mean score as per the ALS-FRS and FVC were 25.65 ± 10.55 and 67% ± 21, respectively. Cardiac parasympathetic dysautonomia was found in 4 out of 17 (25%) ALS patients vs. none of the controls (P = 0.031). ALS patients with reduced RRIV did not differ statistically in any variably from those without. Only 1 patient (6%) vs. none of the controls had orthostatic hypotension (P  = 0.18).

Conclusion

Parasympathetic cardiac dysautonomia was observed in 25% of the ALS patients. Lack of association with epidemiological or ALS-related variables suggests a different pathological process.