Cardiopulmonary complications in multiple sclerosis patients: A systematic review

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease primarily affecting the central nervous system. Increasing evidence suggests that MS also involves systemic complications, particularly within the cardiovascular and respiratory systems. This systematic review aimed to synthesize recent evidence regarding cardiopulmonary complications in individuals with MS. A systematic search of PubMed, Scopus, Web of Science, CINAHL, and ScienceDirect was conducted for studies published between 2020 and 2025. The review followed PRISMA 2020 reporting guidelines. Studies addressing cardiovascular dysfunction, respiratory impairment, or cardiopulmonary outcomes in MS patients were included. Ten studies met the inclusion criteria. Evidence indicates that autonomic cardiovascular dysfunction, reduced heart rate variability, respiratory muscle weakness, reduced pulmonary capacity, and sleep‑disordered breathing are common in individuals with MS. Physical activity and respiratory muscle training demonstrated beneficial effects on cardiopulmonary function. Cardiopulmonary complications represent clinically important yet often underrecognized manifestations of MS. Early screening, multidisciplinary care, and targeted rehabilitation interventions may significantly improve functional outcomes and quality of life for individuals living with MS.