Ambulatory ECG and analysis of heart rate variability in Parkinson's disease

Haapaniemi, Tarja H.; Pursiainen, Ville; Korpelainen, Juha T.; Huikuri, Heikki V.; Sotaniemi, K. A.; Myllylä, Vilho V.

doi:10.1136/jnnp.70.3.305

Cited by 158 publications

(142 citation statements)

References 42 publications

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“…In keeping with such an inability to shift the cardiac sympathovagal balance toward a sympathetic predominance, the increase of the LF/HF ratio during tilt was reduced in PD compared with control subjects, similarly to PDOH subjects. A dynamic impairment of cardiac sympathetic modulation in accordance with our results has already been described by power spectrum analysis of RR variability during 24-hour ECG recordings 34 and the tilt maneuver. 10 In the PD group, despite the absence of orthostatic hypotension, the tilt-induced increase of LF SAP was blunted compared with control subjects, similar to PDOH subjects.…”

Section: Cardiovascular and Autonomic Changes Induced By A Gravitatiosupporting

confidence: 77%

“…34 Finally, immunohistochemical staining of postmortem specimens of cardiac tissue showed a decreased number of sympathetic axons innervating the left anterior ventricular wall of the heart of 4 patients suffering from Parkinson's disease. 15 Based on cardiac norepinephrine spillover, 18 immunohistochemical staining 15 methodologies, and the presence of Lewy bodies in ganglionic cells and axons of the paravertebral sympathetic chain, 35 the concomitant presence of a peripheral sympathetic denervation disease has been hypothesized recently in Parkinson's disease.…”

Section: Cardiovascular and Autonomic Profile Of Parkinson's Disease mentioning

confidence: 99%

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Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

et al. 2007

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Abstract-Cardiac autonomic abnormalities have been described in Parkinson's disease. Little is known about possible alterations of vascular sympathetic regulatory activity in patients without orthostatic hypotension or symptoms of orthostatic intolerance. Nineteen patients with Parkinson's disease without orthostatic hypotension (PD), 21 with orthostatic hypotension (PDOH), and 20 healthy controls underwent ECG, beat-to-beat arterial pressure, and respiration recordings while recumbent and during a 75°head-up tilt. Spectrum analysis of RR interval and systolic arterial pressure (SAP) variability provided indices of cardiac sympathovagal interaction (low frequency [LF]/high frequency [HF]) to the sinoatrial node and sympathetic vasomotor control (LF SAP ). Arterial baroreceptor mechanisms were assessed by the spontaneous sequences technique and bivariate spectrum analysis (␣ index). Plasma catecholamines provided the neurohormonal profile. At rest, hemodynamics and spectral markers of autonomic function were similar in PD and control subjects. Norepinephrine was lower in PD and PDOH than in control subjects. In PDOH, SAP was higher, whereas LF/HF ratio and LF SAP were lower compared with control subjects. During tilt, SAP was unchanged in PD; however, similar to PDOH, the increase of heart rate, LF/HF ratio, and LF SAP was blunted compared with control subjects. Baroreflex indices were unmodified in PD and PDOH compared with control subjects. Initial alterations in both cardiac and vascular sympathetic modulatory activity were found in PD and revealed by a gravitational stimulus. Prompt recognition of sympathetic abnormalities might result in earlier therapeutic intervention, reduced orthostatic intolerance, and increased quality of life.

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Section: Cardiovascular and Autonomic Changes Induced By A Gravitatiosupporting

confidence: 77%

Section: Cardiovascular and Autonomic Profile Of Parkinson's Disease mentioning

confidence: 99%

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

et al. 2007

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“…To the best of our knowledge, prior studies have focused on group comparisons ,ofter reaching contradictory results [1,3,16,20,21,25,28,29,32,33,35]. It should be noted that, even if a significant statistical difference associated to a certain feature is consistently revealed across several studies, this is not sufficient to demonstrate its potential application to the clinical necessity of single-subject characterization.…”

Section: Discussionmentioning

confidence: 80%

“…According to the study by Haapaniemi et al [16], when analyzing 24h ECG recordings all HRV spectral components were found to be significantly lower in PD patients when compared to controls [16]. In another study, which evaluated 10 consecutive minutes of resting ECG recordings, HRV High Frequency (HF) power (thought to mainly reflect parasympathetic activity)…”

Section: Introductionmentioning

confidence: 99%

Assessment of spontaneous cardiovascular oscillations in Parkinson's disease

Valenza

Orsolini

Diciotti

et al. 2016

Biomedical Signal Processing and Control

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Parki so 's disease PD has ee reported to i ol e postga glio i s patheti failure and a wide spectrum of autonomic dysfunctions including cadiovascular, sexual, bladder, gastrointestinal and sudo-motor abnormalities. While these symptoms may have a significant impact on daily activities, as well as quality of life, the evaluation of autonomic nervous system (ANS) dysfunctions relies on a large and expensive battery of autonomic tests only accessible in highly specialized laboratories. In this paper we aim to devise a comprehensive computational assessment of disease-related heartbeat dynamics based on instantaneous, time-varying estimates of spontaneous (resting state) cardiovascular oscillations in PD. To this end, we combine standard ANS-related heart rate variability (HRV) metrics with measures of instantaneous complexity (dominant Lyapunov exponent and entropy) and higher-order statistics (bispectra). Such measures are computed over 600-s recordings acquired at rest in 29 healthy subjects and 30 PD patients. The only significant group-wise differences were found in the variability of the dominant Lyapunov exponent. Also, the best PD vs. healthy controls classification performance (balanced accuracy: 73.47%) was achieved only when retaining the time-varying, non-stationary structure of the dynamical features, whereas classification performance dropped significantly (balanced accuracy: 61.91%) when excluding variability-related features. Additionally, both linear and nonlinear model features correlated with both clinical and neuropsychological assessments of the considered patient population.Our results demonstrate the added value and potential of instantaneous measures of heartbeat dynamics and its variability in characterizing PD-related disabilities in motor and cognitive domains.3

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“…8 The variation of heart rate with respiration is known as sinus arrhythmia. 12,14,15 Inspiration increases and expiration decreases the heart rate.…”

Section: Important Tests Used For Evaluation Of Autonomic Functionsmentioning

confidence: 99%

Autonomic nervous system dysfunction in Parkinson’s disease patients

Ezhumalai

Ravikumar

2017

Int J Res Med Sci

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Background: Parkinson’s disease (PD) PD ranks second among the common neurodegenerative disease next only to Alzheimer’s dementia. Autonomic symptoms in Parkinson’s disease is very common. This study assesses the autonomic dysfunction in PD, their prevalence, type and severity in related to staging.Methods: The study was conducted in Rajiv Gandhi government general hospital, Institute of neurology Madras medical college between 2011 to 2013, 141 patients fulfilling the criteria of Parkinson’s disease brain bank society were included in the study. All the patients were clinically examined with special attention to history, clinical features and symptoms and signs of Autonomic dysfunction. The patients were graded using the Hoehn and Yahr staging system.Results: Among 141 patients, 118 (83.7%) had autonomic dysfunction. Among 87 males, 72 patients had ANS dysfunction and among 54 females, 46 patients had ANS dysfunction. Stage wise 39 patients of 53 patients (73.6%) belonging to Stage I; 37 of 44 (84.1%) belonging to Stage II; 26 of 28 (92.8%) belonging to Stage III and all patients belonging to Stage IV and V had ANS dysfunction.Conclusions: ANS dysfunction in Parkinson’s disease is a common problem and the prevalence of it is 82.75% in males and 85.2% in females and overall in 83.7% of patients. The prevalence of ANS dysfunction in Males and females increases as the Hoehn and Yahr stage increases as evidenced by 68.7% of males and 80.9% of females have ANS dysfunction in stage I, while 100% of males and females in stage IV and V have ANS dysfunction. Sexual dysfunction (84.7%) ranks first followed by gastrointestinal (56.9%), and thermoregulatory (51.3%) autonomic disturbances in males and urinary disturbances (78.3%), ranks first followed by thermoregulatory (65.2%), and cardiovascular disturbances (56.5%) in females.

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Ambulatory ECG and analysis of heart rate variability in Parkinson's disease

Cited by 158 publications

References 42 publications

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

Assessment of spontaneous cardiovascular oscillations in Parkinson's disease

Autonomic nervous system dysfunction in Parkinson’s disease patients

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