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Syncope and autonomic cardiovascular dysfunction in Parkinson disease
Affiliations- Klinika Neurologii i Epileptologii, Instytut “Pomnik – Centrum Zdrowia Dziecka” w Warszawie
- Zakład Medycyny Nuklearnej, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Poland
- First Department of Cardiology, Medical University of Gdansk, Gdansk I Klinika Kardiologii, Gdański Uniwersytet Medyczny, Gdańsk
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Abstract
The aim of the study was to investigate the relationship between syncope or presyncope occurrence and dysfunction of the cardiovascular autonomic system in patients with Parkinson disease (PD).
Material and methodsTwenty-four PD patients were studied, including 10 subjects with syncope/presyncope and 14 controls without those symptoms. Ambulatory blood pressure monitoring (ABPM), Holter electrocardiographic monitoring, carotid sinus massage, tilt test, and cardiac scintigraphy with 123I metaiodobenzylguanidine (MIBG) were performed.
ResultsDifferences between the two groups were found in myocardial scintigraphy and ABPM. The stepwise regression analyses suggest that the values of late phase reduced uptake of MIBG (95% CI: 0.0–0.77; p < 0.05) and daytime minimum systolic blood pressure (95% CI: 0.78–0.98; p = 0.007) may be related to the occurrence of syncope/presyncope.
ConclusionsThe findings suggest an association between syncope/presyncope occurrence and dysfunction of the cardiovascular autonomic system in PD patients. Both 123I MIBG myocardial scintigraphy and ABPM may help identify a group of patients with an elevated risk for syncopic episodes which, in turn, may affect the choice of treatment.
Abstract
The aim of the study was to investigate the relationship between syncope or presyncope occurrence and dysfunction of the cardiovascular autonomic system in patients with Parkinson disease (PD).
Material and methodsTwenty-four PD patients were studied, including 10 subjects with syncope/presyncope and 14 controls without those symptoms. Ambulatory blood pressure monitoring (ABPM), Holter electrocardiographic monitoring, carotid sinus massage, tilt test, and cardiac scintigraphy with 123I metaiodobenzylguanidine (MIBG) were performed.
ResultsDifferences between the two groups were found in myocardial scintigraphy and ABPM. The stepwise regression analyses suggest that the values of late phase reduced uptake of MIBG (95% CI: 0.0–0.77; p < 0.05) and daytime minimum systolic blood pressure (95% CI: 0.78–0.98; p = 0.007) may be related to the occurrence of syncope/presyncope.
ConclusionsThe findings suggest an association between syncope/presyncope occurrence and dysfunction of the cardiovascular autonomic system in PD patients. Both 123I MIBG myocardial scintigraphy and ABPM may help identify a group of patients with an elevated risk for syncopic episodes which, in turn, may affect the choice of treatment.
Keywords
myocardial scintigraphy, Parkinson disease, syncope
About this articleTitle
Syncope and autonomic cardiovascular dysfunction in Parkinson disease
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
335-341
Page views
249
Article views/downloads
353
DOI
10.1016/S0028-3843(14)60104-3
Bibliographic record
Neurol Neurochir Pol 2011;45(4):335-341.
Keywords
myocardial scintigraphy
Parkinson disease
syncope
Authors
Marta Leńska-Mieciek
Ingeborga Derecka-Charzyńska
Urszula Fiszer
Leszek Królicki
Piotr Kułakowski
