Cardiovascular fingolimod effects on rapid baroreceptor unloading are counterbalanced by baroreflex resetting

Background and purpose Initial cardiovascular fingolimod effects might compromise baroreflex responses to rapid blood pressure (BP) changes during common Valsalva-like maneuvers. This study evaluated cardiovascular responses to Valsalva maneuver (VM)-induced baroreceptor unloading and loading upon f...

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Bibliographic Details
Published in:Neurological sciences 2021, Vol.42 (1), p.111-121
Main Authors: Hilz, Max J., Roy, Sankanika, de Rojas Leal, Carmen, Liu, Mao, Canavese, Francesca, Winder, Klemens, Hoesl, Katharina M., Lee, De-Hyung, Linker, Ralf A., Wang, Ruihao
Format: Article
Language:English
Subjects:
Autonomic Nervous System in Clinical Practice
Baroreceptors
Baroreflex
Blood Pressure
Cardiovascular system
Fingolimod Hydrochloride
Heart Rate
Hospitals
Humans
Medicine
Medicine & Public Health
Multiple sclerosis
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Original
Original Article
Pressoreceptors
Psychiatry
Reflexes
Unloading
Vagus nerve
Valsalva Maneuver
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Summary:Background and purpose Initial cardiovascular fingolimod effects might compromise baroreflex responses to rapid blood pressure (BP) changes during common Valsalva-like maneuvers. This study evaluated cardiovascular responses to Valsalva maneuver (VM)-induced baroreceptor unloading and loading upon fingolimod initiation. Patients and methods Twenty-one patients with relapsing-remitting multiple sclerosis performed VMs before and 0.5, 1, 2, 3, 4, 5, and 6 hours after fingolimod initiation. We recorded heart rate (HR) as RR intervals (RRI), systolic and diastolic BP (BPsys, BPdia) during VM phase 1, VM phase 2 early, VM phase 2 late, and VM phase 4. Using linear regression analysis between decreasing BPsys and RRI values during VM phase 2 early, we determined baroreflex gain (BRG) reflecting vagal withdrawal and sympathetic activation upon baroreceptor unloading. To assess cardiovagal activation upon baroreceptor loading, we calculated Valsalva ratios (VR) between maximal and minimal RRIs after strain release. Analysis of variance or Friedman tests with post hoc analysis compared corresponding parameters at the eight time points (significance: p  
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-020-05004-1