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Cardiorenal Sympathetic Denervation and Baroreflex Failure in Parkinson Disease with Orthostatic Hypotension
Author(s) -
Goldstein David S,
Sewell LaToya,
Holmes Courtney S
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.1052.4
Subject(s) - baroreflex , medicine , orthostatic vital signs , denervation , pure autonomic failure , cardiology , valsalva maneuver , blood pressure , anesthesia , heart rate
Background About 40% of Parkinson disease (PD) patients have orthostatic hypotension (OH). We tested whether cardiac and renal sympathetic denervation and baroreflex failure characterize PD+OH. Methods PD patients were stratified into two groups based on presence or absence of OH. Interventricular septum and renal cortex 6‐[18F]fluorodopamine‐derived radioactivity by positron emission tomography were expressed as ratios of liver radioactivity. Baroreflex‐cardiovagal function was assessed by interbeat interval‐systolic pressure relationships during the Valsalva maneuver and baroreflex‐sympathoneural function by fractional orthostatic increments in plasma norepinephrine (NE). Results The PD+OH group had low mean septum:liver and renal cortex:liver ratios (p<0.0001, p=0.02), low baroreflex‐cardiovagal gain (p<0.0001), and small orthostatic increments in plasma NE (p<0.0001). Baroreflex‐cardiovagal gain and the fractional increment in plasma NE were closely related to septum:liver ratios (p<0.0001; p=0.009) and weakly related to cortex:liver ratios (p=0.05; p=0.09). Septum:liver and renal cortex:liver ratios were positively correlated (p=0.0001). Conclusions In PD, renal and cardiac noradrenergic denervation and baroreflex failure are associated with OH. Source of research support: Intramural Research Program, NINDS, NIH