Objective: The study aimed to assess cardiac autonomic dysfunction in patients with multiple system atrophy (MSA).

Background: MSA is a progressive neurodegenerative disorder with predominant autonomic dysfunction. Autonomic function testing helps in treatment planning and assessing disease prognosis in patients with MSA.

Method:
It is a prospective two-group comparative study. Fifteen MSA patients (56.6 ± 7.1 years) and 15 healthy volunteers (57.9 ± 11.3 years) were the study subjects. Various parameters of short term heart rate variability, baroreceptor sensitivity, and tilt table test was assessed.

Results: Among the short term HRV parameters, total power, low-frequency power, and high-frequency power were lower in MSA patients (p<0.001). LF/HF ratio was higher in the MSA group compared to healthy volunteers (p<0.001). Total baroreceptor sensitivity (BRS) was lower in MSA patients (p<0.001). Seven MSA patients (46.6%) had orthostatic hypotension (OH) (Immediate OH=3; Delayed OH: 4). The median drop in Systolic BP was 31 mmHg and diastolic BP was 12mmHg.

Conclusion: There is cardiac autonomic dysfunction in MSA patients as evidenced by reduced HRV (Total power), reduced total BRS, and orthostatic hypotension. There was a sympathovagal imbalance with sympathetic dominance in MSA patients. These findings imply that MSA patients have a poor prognosis and are at an increased risk of cardiovascular co-morbid disorders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cardiac-autonomic-dysfunction-in-patients-with-multiple-system-atrophy-a-cross-sectional-study/