STRUCTURAL AND FUNCTIONAL ALTERATIONS OF THE CARDIOVASCULAR SYSTEM IN PARKINSON´S DISEASE

Background: The known influence of the Parkinson´s disease (PD) on the cardiovascular system is mainly the autonomic dysfunction which is manifested in postural hypotension, chronotropic insufficiency, and reduced heart rate variability. Other effects, e.g. stress response, arrhythmia occurrence and changes in heart morphology are still the object to clarify.
Objectives: To study the heart rate and blood pressure reaction during exercise, advanced measurements of heart volumes and mass using cardiac magnetic resonance (CMR) and occurrence of arrhythmias in PD patients.
Methods: Thirty PD patients (19 men, mean age 57.5 years), without previous history of cardiac disorders underwent bicycle ergometry, ECG Holter monitoring and CMR. The parameters from ergometry and CMR were compared with controls (24 subjects for ergometry, 20 for CMR).
Results: PD patients had lower systolic blood pressure (SBP) at rest 117.8 vs 128.3 mmHg; p<0.01; and also lower peak SBP after exercise: 155.8 vs 170.8 mmHg; p<0.05, and lower increase of heart rate (HR) during exercise: 49.7 vs 64.3 beats per minute (BPM); pConclusion: Our study used combination of functional and structural assessment and showed that PD is associated with deterioration of blood pressure and heart rate response to exercise, increased myocardial mass and heart volumes compared to controls, and also a high prevalence of atrial fibrillation.