Balal Mehmet, Demirkiran Meltem, Paydas Saime
Çukurova Univeristy, Medicine School, Department of Neurology, Adana 01031, Turkey.
Çukurova Univeristy, Medicine School, Department of Nephrology, Adana 01031, Turkey.
Parkinsons Dis. 2022 Jul 12;2022:6723950. doi: 10.1155/2022/6723950. eCollection 2022.
Cardiovascular autonomic dysfunction, which leads to hemodynamic disorders, is commonly observed in patients with Parkinson's disease (PD). Central aortic pressure (CAP) is the systolic blood pressure (SBP) at the root of the aorta. In young people, CAP is lower than peripheral arterial blood pressure. In older people, the difference between CAP and peripheral arterial blood pressure decreases depending on the extent of arterial stiffness (AS). In patients with AS, CAP increases. CAP is thus regarded as an indicator of AS.
To compare CAP and other hemodynamic parameters for AS between patients with Parkinson's disease and control group. We also aimed to evaluate changes in these hemodynamic parameters after the levodopa (LD) intake.
We included 82 patients with PD and 76 healthy controls. Age, sex, disease duration, disease subtype, Hoehn-Yahr stage (H&Y), and nonmotor symptoms (NMS) were documented. TensioMed Software v.3.0.0.1 was used to measure CAP, peripheral arterial blood pressure, pulse pressure (PP), heart rate (HR), mean arterial pressure (MAP), augmentation index (AI), pulse wave velocity, and ejection time. All patients were being treated with LD, and measurements were performed 1 h before and 1 h after LD intake.
Baseline peripheral arterial blood pressure and CAP values were significantly higher in the PD group than in the control group ( < 0.001 and =0.02, respectively). Most cardiac hemodynamic parameters, including peripheral arterial blood pressure and CAP, decreased significantly ( < 0.02 and < 0.001, respectively) after LD intake in the PD group. Disease subtype, duration, and severity did not affect any of the hemodynamic parameters. When NMS were evaluated, patients with psychosis and dementia showed higher baseline parameters.
Loss of postganglionic noradrenergic innervation is well-known with PD. Several cardiac hemodynamic parameters were affected, suggesting cardiac autonomic dysfunction in these patients. The data obtained were independent of disease severity, duration, and subtype. After LD intake, most of these parameters decreased, which might have a positive effect on the vascular burden.
心血管自主神经功能障碍会导致血流动力学紊乱，在帕金森病（PD）患者中较为常见。中心主动脉压（CAP）是主动脉根部的收缩压（SBP）。在年轻人中，CAP低于外周动脉血压。在老年人中，CAP与外周动脉血压之间的差异会根据动脉僵硬度（AS）的程度而减小。在AS患者中，CAP会升高。因此，CAP被视为AS的一个指标。
比较帕金森病患者与对照组之间的CAP及其他AS血流动力学参数。我们还旨在评估左旋多巴（LD）摄入后这些血流动力学参数的变化。
我们纳入了82例PD患者和76例健康对照。记录了年龄、性别、病程、疾病亚型、Hoehn-Yahr分期（H&Y）和非运动症状（NMS）。使用TensioMed Software v.3.0.0.1测量CAP、外周动脉血压、脉压（PP）、心率（HR）、平均动脉压（MAP）、增强指数（AI）、脉搏波速度和射血时间。所有患者均接受LD治疗，并在LD摄入前1小时和摄入后1小时进行测量。
PD组的基线外周动脉血压和CAP值显著高于对照组（分别为<0.001和=0.02）。PD组LD摄入后，包括外周动脉血压和CAP在内的大多数心脏血流动力学参数显著降低（分别为<0.02和<0.001）。疾病亚型、病程和严重程度均未影响任何血流动力学参数。在评估NMS时，患有精神病和痴呆的患者基线参数较高。
PD患者节后去甲肾上腺素能神经支配丧失是众所周知的。几个心脏血流动力学参数受到影响，提示这些患者存在心脏自主神经功能障碍。获得的数据与疾病严重程度、病程和亚型无关。LD摄入后，这些参数中的大多数降低，这可能对血管负担有积极影响。
