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Early abnormalities of vascular and cardiac autonomic control in Parkinson's disease without orthostatic hypotension.
Hypertension. 2007 Jan; 49(1):120-6.H

Abstract

Cardiac autonomic abnormalities have been described in Parkinson's disease. Little is known about possible alterations of vascular sympathetic regulatory activity in patients without orthostatic hypotension or symptoms of orthostatic intolerance. Nineteen patients with Parkinson's disease without orthostatic hypotension (PD), 21 with orthostatic hypotension (PDOH), and 20 healthy controls underwent ECG, beat-to-beat arterial pressure, and respiration recordings while recumbent and during a 75 degrees head-up tilt. Spectrum analysis of RR interval and systolic arterial pressure (SAP) variability provided indices of cardiac sympathovagal interaction (low frequency [LF]/high frequency [HF]) to the sinoatrial node and sympathetic vasomotor control (LF(SAP)). Arterial baroreceptor mechanisms were assessed by the spontaneous sequences technique and bivariate spectrum analysis (alpha index). Plasma catecholamines provided the neurohormonal profile. At rest, hemodynamics and spectral markers of autonomic function were similar in PD and control subjects. Norepinephrine was lower in PD and PDOH than in control subjects. In PDOH, SAP was higher, whereas LF/HF ratio and LF(SAP) were lower compared with control subjects. During tilt, SAP was unchanged in PD; however, similar to PDOH, the increase of heart rate, LF/HF ratio, and LF(SAP) was blunted compared with control subjects. Baroreflex indices were unmodified in PD and PDOH compared with control subjects. Initial alterations in both cardiac and vascular sympathetic modulatory activity were found in PD and revealed by a gravitational stimulus. Prompt recognition of sympathetic abnormalities might result in earlier therapeutic intervention, reduced orthostatic intolerance, and increased quality of life.

Authors+Show Affiliations

Medicina Interna II, Ospedale L. Sacco, Università degli Studi di Milano, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17101845

Citation

Barbic, Franca, et al. "Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson's Disease Without Orthostatic Hypotension." Hypertension (Dallas, Tex. : 1979), vol. 49, no. 1, 2007, pp. 120-6.
Barbic F, Perego F, Canesi M, et al. Early abnormalities of vascular and cardiac autonomic control in Parkinson's disease without orthostatic hypotension. Hypertension. 2007;49(1):120-6.
Barbic, F., Perego, F., Canesi, M., Gianni, M., Biagiotti, S., Costantino, G., Pezzoli, G., Porta, A., Malliani, A., & Furlan, R. (2007). Early abnormalities of vascular and cardiac autonomic control in Parkinson's disease without orthostatic hypotension. Hypertension (Dallas, Tex. : 1979), 49(1), 120-6.
Barbic F, et al. Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson's Disease Without Orthostatic Hypotension. Hypertension. 2007;49(1):120-6. PubMed PMID: 17101845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early abnormalities of vascular and cardiac autonomic control in Parkinson's disease without orthostatic hypotension. AU - Barbic,Franca, AU - Perego,Francesca, AU - Canesi,Margherita, AU - Gianni,Michela, AU - Biagiotti,Sara, AU - Costantino,Giorgio, AU - Pezzoli,Giovanni, AU - Porta,Alberto, AU - Malliani,Alberto, AU - Furlan,Raffaello, Y1 - 2006/11/13/ PY - 2006/11/15/pubmed PY - 2007/1/17/medline PY - 2006/11/15/entrez SP - 120 EP - 6 JF - Hypertension (Dallas, Tex. : 1979) JO - Hypertension VL - 49 IS - 1 N2 - Cardiac autonomic abnormalities have been described in Parkinson's disease. Little is known about possible alterations of vascular sympathetic regulatory activity in patients without orthostatic hypotension or symptoms of orthostatic intolerance. Nineteen patients with Parkinson's disease without orthostatic hypotension (PD), 21 with orthostatic hypotension (PDOH), and 20 healthy controls underwent ECG, beat-to-beat arterial pressure, and respiration recordings while recumbent and during a 75 degrees head-up tilt. Spectrum analysis of RR interval and systolic arterial pressure (SAP) variability provided indices of cardiac sympathovagal interaction (low frequency [LF]/high frequency [HF]) to the sinoatrial node and sympathetic vasomotor control (LF(SAP)). Arterial baroreceptor mechanisms were assessed by the spontaneous sequences technique and bivariate spectrum analysis (alpha index). Plasma catecholamines provided the neurohormonal profile. At rest, hemodynamics and spectral markers of autonomic function were similar in PD and control subjects. Norepinephrine was lower in PD and PDOH than in control subjects. In PDOH, SAP was higher, whereas LF/HF ratio and LF(SAP) were lower compared with control subjects. During tilt, SAP was unchanged in PD; however, similar to PDOH, the increase of heart rate, LF/HF ratio, and LF(SAP) was blunted compared with control subjects. Baroreflex indices were unmodified in PD and PDOH compared with control subjects. Initial alterations in both cardiac and vascular sympathetic modulatory activity were found in PD and revealed by a gravitational stimulus. Prompt recognition of sympathetic abnormalities might result in earlier therapeutic intervention, reduced orthostatic intolerance, and increased quality of life. SN - 1524-4563 UR - https://www.unboundmedicine.com/medline/citation/17101845/Early_abnormalities_of_vascular_and_cardiac_autonomic_control_in_Parkinson's_disease_without_orthostatic_hypotension_ L2 - https://www.ahajournals.org/doi/10.1161/01.HYP.0000250939.71343.7c?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -