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帕金森病患者静息状态下逐搏血压变异性降低。

Reduced resting beat-to-beat blood pressure variability in patients with Parkinson's disease.

作者信息

Guerrero Rosa V D, Sabino-Carvalho Jeann L, Brandão Pedro R P, Neri Jhenny V, Vianna Lauro C

机构信息

NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil.

NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil; Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.

出版信息

Auton Neurosci. 2025 Oct;261:103332. doi: 10.1016/j.autneu.2025.103332. Epub 2025 Jul 28.

Abstract

PURPOSE

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects both motor and non-motor functions, including autonomic regulation. In the cardiovascular system, autonomic dysfunction may result in blood pressure (BP) abnormalities, such as altered variability. Therefore, the present study aimed to test the hypothesis that patients with PD exhibit increased resting beat-to-beat blood pressure variability (BPV) compared to healthy controls.

METHODS

Beat-to-beat heart rate (via electrocardiography) and BP (via photoplethysmography) were continuously recorded in 19 patients with PD, 15 age-matched older adults, and 19 young adults. Cardiac output (CO) and total peripheral resistance (TPR) were estimated using the ModelFlow method. BPV was assessed using several indices, including the standard deviation (SD) and average real variability (ARV).

RESULTS

Compared to both older and younger control groups, patients with PD exhibited lower ARV values for systolic (1.6 ± 0.5 vs. 2.3 ± 0.5 and 3.1 ± 1.1 mm Hg, P = 0.001), diastolic (0.9 ± 0.2 vs. 1.1 ± 0.4 and 1.5 ± 0.6 mm Hg, P = 0.001), and mean (0.9 ± 0.2 vs. 1.2 ± 0.4 and 1.5 ± 0.5 mm Hg, P = 0.001) BP. In addition, patients with PD showed reduced ARV in TPR compared to the older control group (0.5 ± 0.2 vs. 0.7 ± 0.7 mm Hg/L/min, P = 0.045). However, ARV in CO did not differ significantly between PD patients and older adults (119 ± 68 vs. 136 ± 48 mL/min, P = 0.806). Similar patterns were observed when using other BPV indices.

CONCLUSION

These findings suggest that Parkinson's disease may lead to a reduction in beat-to-beat blood pressure variability, potentially driven by changes in total peripheral resistance rather than cardiac output.

摘要

目的

帕金森病(PD)是一种进行性神经退行性疾病,会影响运动和非运动功能,包括自主调节功能。在心血管系统中,自主神经功能障碍可能导致血压(BP)异常,如变异性改变。因此,本研究旨在验证以下假设:与健康对照组相比,帕金森病患者静息时逐搏血压变异性(BPV)增加。

方法

连续记录19例帕金森病患者、15例年龄匹配的老年人和19例年轻人的逐搏心率(通过心电图)和血压(通过光电容积脉搏波描记法)。使用ModelFlow方法估算心输出量(CO)和总外周阻力(TPR)。使用包括标准差(SD)和平均实际变异性(ARV)在内的多个指标评估BPV。

结果

与老年和年轻对照组相比,帕金森病患者的收缩压ARV值较低(1.6±0.5 vs. 2.3±0.5和3.1±1.1 mmHg,P = 0.001),舒张压ARV值较低(0.9±0.2 vs. 1.1±0.4和1.5±0.6 mmHg,P = 0.001)以及平均血压ARV值较低(0.9±0.2 vs . 1.2±0.4和1.5±0.5 mmHg,P = 0.001)。此外,与老年对照组相比,帕金森病患者的TPR中ARV降低(0.5±0.2 vs. 0.7±0.7 mmHg/L/min,P = 0.045)。然而,帕金森病患者与老年人之间的CO中ARV无显著差异(119±68 vs. 136±48 mL/min,P = 0.806)。使用其他BPV指标时也观察到类似模式。

结论

这些发现表明,帕金森病可能导致逐搏血压变异性降低,这可能是由总外周阻力而非心输出量的变化所驱动。

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