PR Prolongation and Cardiac ¹²³I-MIBG Uptake Reduction in Parkinson's Disease

Abstract

Background: Cardiac ¹²³I-metaiodobenzylguanidine scintigraphy (MIBG) previously demonstrated an uptake reduction in patients with Parkinson's disease (PD). However, epidemiologic research showed that electrocardiography (ECG) abnormalities occurred prior to motor signs in PD. Here we investigated whether the electrical conduction system of the heart was impaired in PD. Methods: Clinical features, ECG and MIBG parameters were analyzed in 191 patients with PD, 42 with multiple system atrophy (MSA) and 124 normal controls (NL). Results: The PR interval was significantly longer in patients with PD than in NL. The PR interval was significantly negatively correlated with early and delayed heart-to-mediastinum ratios in MIBG scintigraphy in PD and MSA patients. In 19 PD patients with PR prolongation, 17 patients also had abnormal MIBG findings, and the other 2 showed normal MIBG. Conclusions: The PR prolongation must show some sympathetic system abnormality because it is mainly controlled by the sympathetic nervous system. PR prolongation supports the objective biomarker value of MIBG for PD diagnosis.

Electrocardiogram Characteristics of Different Motor Types of Parkinson’s Disease

“…In addition, the present study was consistent with the scholars' reports. 9 In the present study, it was found that the QT interval was positively correlated with the disease course and Hoehn-Yahr classification. The QT interval represents the total time course of ventricular depolarization and repolarization.…”

“…Foreign scholars have studied 191 patients with PD and found that results of MIBG scintigraphy in 19 PR patients were abnormal. 9 Meanwhile, in the present study, it was found that PR is correlated to the Hoehn-Yahr classification. It was further speculated that the prolongation of PR could be used as a biomarker for autonomic nerve dysfunction in PD.…”

Clinical features and electrocardiogram parameters in Parkinson’s disease

“…In our previous studies of patients with PD, the PR interval was correlated with autonomic dysfunction, and autonomic dysfunction was associated with BMI increase. 2,3 The results of the current study indicated a positive correlation between BMI and the PR and QRS intervals. In a large-scale study of normal subjects, prolongation of both the PR and QRS intervals were reported in obese people.…”

“…1 Recently, prolongation of the PR interval on electrocardiogram (ECG) was reported to reflect the abnormal MIBG findings in PD. 2 In addition, an increased body mass index (BMI) was associated with autonomic dysfunction in PD as determined using the MIBG method. 3 In this study, we investigated the relation between clinical features, including BMI, and ECG parameters in patients with PD.…”

A Randomized Thorough QT Study of Apomorphine Sublingual Film in Patients With Parkinson's Disease

“…1,6 Patients with PD may be predisposed to a prolonged QT interval and are at risk of developing other cardiac abnormalities compared with healthy aged-matched individuals. 7,8 The tendency towards a prolonged QT interval in some patients is likely attributable to autonomic cardiac dysfunction resulting from neuronal degeneration. 9 Risk factors include advanced PD and confounding medications used in PD management, such as domperidone, amantadine, and antidepressants including citalopram and amitriptyline.…”