Cardiac denervation occurs independent of orthostatic hypotension and impaired heart rate variability in Parkinson's disease

Haensch, Carl-Albrecht; Lerch, H; Jörg, Johannes; Isenmann, Stefan

doi:10.1055/s-0028-1086777

Cited by 19 publications

(32 citation statements)

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“…LF power was unrelated to cardiac sympathetic innervation as indicated by interventricular septal myocardial 6-[ 18 F] fluorodopamine-derived radioactivity. Analogously, a recent study found no relationship between heart rate variability assessed in the frequency domain and myocardial uptake of 123 I-metaiodobenzylguanidine, another neuroimaging measure of cardiac sympathetic innervation, in patients with Parkinson disease [17]. Other studies have noted no correlation between LF power and the rate of entry of norepinephrine into cardiac venous plasma, a neurochemical index of cardiac sympathetic tone [3, 5, 19, 21].…”

Section: Discussionmentioning

confidence: 99%

“…The system includes parasympathetic cholinergic and sympathetic noradrenergic components. Clinicians and researchers have long sought valid, non-invasive, quantitative means to identify pathophysiologically relevant abnormalities of “sympathovagal balance” [17]. …”

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confidence: 99%

“…Cardiac sympathetic denervation detected by 123 I-metaiodobenzylguanidine scanning also is unrelated to the LF:HF ratio, a putative index of sympathovagal balance, in patients with Parkinson disease [17]. Moreover, drugs that increase release of norepinephrine from cardiac sympathetic nerves can increase LF power even in patients with neuroimaging evidence of cardiac sympathetic denervation [21].…”

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confidence: 99%

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Low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation

et al. 2011

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Objective Power spectral analysis of heart rate variability is used clinically to assess cardiac autonomic function. High frequency power is related to respiratory sinus arrhythmia and therefore to parasympathetic cardiovagal tone. The relationship of low frequency (LF) power to cardiac sympathetic tone is less clear. We reported previously that LF power may reflect baroreflex function; however, in the previous study LF power was not adjusted for possible influences of respiration. In this study we assessed relationships of LF power, including respiration-adjusted LF power (LFa) using the ANSAR ANX 3.0 device, with cardiac sympathetic innervation and baroreflex function in chronic autonomic failure patients who either had or did not have neuroimaging evidence of cardiac sympathetic denervation. Methods Values for LF power with patients seated at baseline and during the Valsalva maneuver were compared between groups with low or normal myocardial concentrations of 6-[18F]fluorodopamine-derived radioactivity. Baroreflex-cardiovagal gain (BRS) was calculated from the slope of cardiac interbeat interval vs. systolic pressure during the Valsalva maneuver with subjects supine. Results Individual values for LF and LFa were unrelated to myocardial 6-[18F]fluorodopamine-derived radioactivity. During both sitting rest and the Valsalva maneuver the logs of LF and LFa correlated positively with the log of BRS (r=0.61, p=0.0005; r=0.47, p=0.009; r=0.69, p<0.0001; r=0.60, p=0.0006). Patients with low BRS (≤3 msec/mm Hg) had low LF and LFa regardless of the status of cardiac innervation. Conclusion LF and LFa reflect baroreflex function independently of cardiac sympathetic innervation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation

et al. 2011

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“…MIBG uptake was measured on average after 5:05 h (range 4:36–5:28 h). The H/M ratio was compared with the normal range of >1.7, as derived from earlier investigations 18. Reproducibility of the region drawings by three independent investigators is high, with a maximum error of about 5%.…”

Section: Methodsmentioning

confidence: 97%

Cardiac neurotransmission imaging with 123I-meta-iodobenzylguanidine in postural tachycardia syndrome

Haensch

Lerch

Schlemmer

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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“…Symptoms are considered related to postganglionic synucleinopathy of sympathetic and to a lesser degree of parasympathetic innervation of the heart (35). Frequent symptoms are related to reduced baroreflex and orthostatic hypotension.…”

Section: Autonomic Symptomsmentioning

confidence: 99%

Are dysautonomic and sensory symptoms present in early Parkinson’s disease?

Tysnes

Müller

Larsen

2010

Acta Neurologica Scandinavica

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Parkinson's disease (PD) occurs with an annual incidence of 13/100.000, is slightly more frequent in men and is characterized by the motor symptoms tremor, rigidity, bradykinesia and postural instability. In addition, non-motor symptoms have been increasingly connected to the disease although already described in James Parkinson's 'Essay on the shaking palsy' from 1817. The motor symptoms in PD are related to the degeneration of dopaminergic cells in the substantia nigra (SN). These symptoms respond well to dopaminergic substitution. It is much more unclear whether non-motor symptoms like dysautonomia, insomnia, day-time sleepiness, fatigue, pain and neuropsychiatric symptoms respond to levodopa. Autonomic symptoms include dizziness because of orthostatic hypotension, constipation, nausea, voiding symptoms and increased sweating. Such symptoms as well as sensory symptoms like hyposmia and pain are very frequently reported in PD and seem to occur early in the disease process. Braak proposed a sequential model of neuropathology in PD starting with affection of the olfactory bulb and the autonomic innervation of the heart and gut. Affection of SN is seen from Braak stage 3, and limbic and cortical structures are affected in the later stages of the disease. Currently, the evidence for sensory and autonomic involvement in PD is reviewed with special focus on the early phase of the disease.

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Cardiac denervation occurs independent of orthostatic hypotension and impaired heart rate variability in Parkinson's disease

Cited by 19 publications

References 0 publications

Low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation

Low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation

Cardiac neurotransmission imaging with 123I-meta-iodobenzylguanidine in postural tachycardia syndrome

Are dysautonomic and sensory symptoms present in early Parkinson’s disease?

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