Open Access Review Article

Amyotrophic Lateral Sclerosis and Cardiac Function: How can we do with Hummingbird’s Racing Hearts?

Marco Orsini1, Acary Souza Bulle Oliveira2, Marcos RG de Freitas3, Jacqueline Fernandes do Nascimento 4, Renata Castro4, Carlos Henrique Melo Reis4, Valéria Camargo Silveira4, Antônio Marcos da Silva Cathatino4, Rodrigo Silva de Brito5, Bruno Vaz Kerges Bueno6, Fábio Fernandes6, Carlos Eduardo Cardoso7, Adriano Leico Oda2, Mauricio de Sant’ and Anna Junior8

1Master Program in Neurology, Vassouras University and Iguaçu University, UNIG, RJ, Brazil

2Federal University of São Paulo, Department of Neurology, SP, Brazil

3Federal University of Rio de Janeiro, Department of Neurology, Rio de Janeiro, RJ, Brazil

4University Iguaçu, RJ, Brazil

5Fluminense Federal University, Faculty of Medicine, Niterói, RJ, Brazil

6Institute of the Heart Hospital das Clínicas FMUSP – Myocardiopathies Group, SP, Brazil

7University of Vassouras – Vassouras, RJ, Brazil

8Federal Institute of Education, Science and Technology of Rio de Janeiro – Physiotherapy Course, RJ, Brazil

Corresponding Author

Received Date: June 19, 2021;  Published Date: July 09, 2021

Amyotrophic lateral sclerosis (ALS) is a degenerative disease that classically affects the motor neuron, causing paralysis, flaccidity and death. However, although its etiopathogenesis is not fully elucidated, it is known that its involvement is not only motor, but also has a strong interaction with the autonomic nervous system, with cardiovascular, gastrointestinal and sleep effects, for example. The disease, which leads to death mainly from respiratory complications, also has underestimated cardiovascular effects, like increased heart rate variability, malignant arrhythmias and sudden death. These aspects raise several questions, such as whether there is a direct correlation between autonomic effects and the underlying disease, whether the onset of autonomic symptoms occurs at an early or late stage of the disease and whether there is an effective therapy to modulate these alterations. A valid question is whether the use of beta-blockers would be effective in modulating symptoms related to increased heart rate and in preventing sudden death and malignant arrhythmias found in some of these patients. It is also important to highlight the role of motor and respiratory physiotherapy in controlling complications of the respiratory system and in improving the quality of sleep of patients with ALS. With this, it is important that we see that amyotrophic lateral sclerosis is not an exclusive motor neuron disease, but has other mechanisms that have not yet been fully clarified, including autonomic changes. Thus, we must direct therapies and studies to these changes, which have a direct impact on the patient’s morbidity, mortality and quality of life.

Keywords:Amyotrophic lateral sclerosis; Autonomic nervous system; Autonomic modulation

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