Objective: To determine frequency of cardiovascular abnormalities and autonomic dysfunction in the early course of Parkinson’s disease

Background: Parkinson´s disease (PD) is a neurodegenerative disease characterized by motor and non-motor complications. Among the latter, abnormalities of the autonomic nervous system such as orthostatic hypotension (OH) prevail. Other autonomic abnormalities (AA) such as nocturnal hypertension (NH) and the loss of nocturnal blood pressure dipping (LNBPD) have been associated to cardiovascular abnormalities (CA) and mortality. The most common CA are left ventricular hypertrophy (LVH), cardiac ischemia, heart failure and arrhythmias.

Method: Cohort, cross-sectional, analytic, quantitative study. 31 patients with PD diagnosed in the previous 5 years and managed in our institution, will be included. A baseline questionnaire, MDSUPDRS, Höehn and Yahr scores will be obtained. Blood pressure (BP) measurements to determine OH. CA will be determined by echocardiography (Echo) to document LVH, BP will be monitored by MAPA to establish NH or LNBPD, Dependent (CA) and independent (AA) variables will be analyzed to determine possible associations. Logistic regression multivariable analysis will be performed to evaluate the role of AA in the variability and magnitude of CA.

Results: 31 patients have been included at the moment, most are male with an average age of 63±10, a 4±1.3 year course of PD and an average MDS-UPDRS III (on state) 25±14.6, Hoën and Yahr 2.0 and Minimental score 26±1.09; symptoms associated to orthostatism were, by frequency, headache and instability when upright. 32.3% patients have been asymptomatic OH; dyspnea was the most frequent cardiovascular symptom followed fatigue. And by Echo, 32.5% of the patients with OH obtained increased ventricular functionality in relation to early diastolic dysfunction. 2 patients had cardiac arrhythmia (1 bigeminism and 1 extrasystole), 8 patients had LVH and 3 had apical hypokinesia without OH (p=.66). MAPA showed LNBPD in 20 patients (62.5%), 41.9% HN with alteration of the minimum systolic and maximum diastolic pressure (p=.09).

Conclusion: So far the patients included in the study have various autonomic and cardiovascular alterations, which are important because they can increase the morbidity and mortality and especially quality of life of patients from the onset of the disease.

References: Goldstein DS. Orthostatic hypotension as an early finding in Parkinson disease. Clin Auton Res 2006;16:46–64 2.- Goldstein DS, Holmes C, Li ST, Bruce S, Metman LV, Cannon III RO. Cardiac sympathetic denervation in Parkinson disease. Ann Intern Med Sep 5 2000;133 (5):338–47.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frequency-of-cardiovascular-abnormalities-in-mexican-patients-with-early-parkinsons-disease/