Department of Cardiology, Ordu University Medical School, Ordu, Turkey.
Department of Neurology, Ordu University Medical School, Ordu, Turkey.
J Geriatr Cardiol. 2016 Jan;13(1):75-80. doi: 10.11909/j.issn.1671-5411.2016.01.003.
Levodopa is the indispensable choice of medial therapy in patients with Parkinson disease (PD). Since L-dopa treatment was shown to increase serum homocysteine levels, a well-known risk factor for cardiovascular disorders, the patients with PD under L-dopa treatment will be at increased risk for future cardiovascular events. The objective of this study is to evaluate cardiovascular risk in patients with PD under levodopa treatment.
The study population consisted of 65 patients with idiopathic PD under L-dopa treatment. The control group included 32 age and gender matched individuals who had no cognitive decline. Echocardiographic measurements, serum homocysteine levels and elastic parameters of the aorta were compared between the patients with PD and controls.
As an expected feature of L-dopa therapy, the Parkinson group had significantly higher homocystein levels (15.1 ± 3.9 µmol/L vs. 11.5 ± 3.2 µmol/L, P = 0.02). Aortic distensibility was significantly lower in the patients with PD when compared to controls (4.8 ± 1.5 dyn/cm(2) vs. 6.2 ± 1.9 dyn/cm(2), P = 0.016). Additionally, the patients with PD had higher aortic strain and aortic stiffness index (13.4% ± 6.4% vs. 7.4% ± 3.6%, P < 0.001 and 7.3 ± 1.5 vs. 4.9 ± 1.9, P < 0.001 respectively). Furthermore, serum homocysteine levels were found to be positively correlated with aortic stiffness index and there was a negative correlation between aortic distensibility and levels of serum homocysteine (r = 0.674, P < 0.001; r = -0.602, P < 0.001, respectively).
The patients with PD under L-dopa treatment have increased aortic stiffness and impaired diastolic function compared to healthy individuals. Elevated serum homocysteine levels may be a possible pathophysiological mechanism.
左旋多巴是治疗帕金森病（PD）患者的不可或缺的药物。由于左旋多巴治疗会导致血清同型半胱氨酸水平升高，而同型半胱氨酸是心血管疾病的一个众所周知的危险因素，因此接受左旋多巴治疗的 PD 患者未来发生心血管事件的风险会增加。本研究的目的是评估接受左旋多巴治疗的 PD 患者的心血管风险。
研究人群包括 65 名正在接受左旋多巴治疗的特发性 PD 患者。对照组包括 32 名年龄和性别匹配、无认知能力下降的个体。比较 PD 患者和对照组之间的超声心动图测量、血清同型半胱氨酸水平和主动脉弹性参数。
正如左旋多巴治疗的预期特征一样，帕金森组的同型半胱氨酸水平显著升高（15.1±3.9µmol/L 比 11.5±3.2µmol/L，P=0.02）。与对照组相比，PD 患者的主动脉扩张性明显较低（4.8±1.5 dyn/cm2 比 6.2±1.9 dyn/cm2，P=0.016）。此外，PD 患者的主动脉应变和主动脉僵硬指数更高（13.4%±6.4%比 7.4%±3.6%，P<0.001 和 7.3±1.5 比 4.9±1.9，P<0.001）。此外，血清同型半胱氨酸水平与主动脉僵硬指数呈正相关，而主动脉扩张性与血清同型半胱氨酸水平呈负相关（r=0.674，P<0.001；r=-0.602，P<0.001）。
与健康个体相比，接受左旋多巴治疗的 PD 患者的主动脉僵硬度增加，舒张功能受损。血清同型半胱氨酸水平升高可能是一种潜在的病理生理机制。
