Heart rhythm variability analysis in patients with Levy body dementiaand in those with Parkinson's disease
Abstract
Cardiac rhythm and its structure are indicators of the state of heart regulatory systems. Estimation of heart rhythm variability (HRV) makes it
possible to detect cardiac autonomic regulatory impairments and to estimate their magnitude, by providing additional possibilities to examine
autonomic disorders and to search for new differential diagnostic distinctions between Levy body dementia (LBD) and Parkinson's disease (PD).
Objective: to analyze autonomic provision of cardiac performance in patients with LBD versus PD patients with and without dementia
(PD+D and PD-D). Subjects and methods. The study enrolled 21 patients with probable LBD and 31 patients with PD (24 patients with PD-D and 7 with
PD+D), who were matched for gender and age.
Results and discussion. Resting heart rhythm analysis revealed no normal age-related abnormalities in patients with LBD as compared to
those with PD+D who had a marked reduction in HRV. An orthostatic test in both patients with LBD and those with PD (mainly that with
dementia) showed inadequate sympathetic effects on heart rhythm, which is suggestive of cardiac sympathetic dysregulation and favors the
development of orthostatic hypotension. During the orthostatic test, the patients with LBD were found to have supraventricular premature
contractions with the pulse being fixed, which were probably caused by the hypersensitivity of denervated receptors to humoral factors. As the
denervation process became longer, receptor sensitivity was decreased, hence supraventricular premature beats and arterial hypertension
were absent in the horizontal position in long ill patients with PD+D, in whom the adaptive properties were considerably lower.
possible to detect cardiac autonomic regulatory impairments and to estimate their magnitude, by providing additional possibilities to examine
autonomic disorders and to search for new differential diagnostic distinctions between Levy body dementia (LBD) and Parkinson's disease (PD).
Objective: to analyze autonomic provision of cardiac performance in patients with LBD versus PD patients with and without dementia
(PD+D and PD-D). Subjects and methods. The study enrolled 21 patients with probable LBD and 31 patients with PD (24 patients with PD-D and 7 with
PD+D), who were matched for gender and age.
Results and discussion. Resting heart rhythm analysis revealed no normal age-related abnormalities in patients with LBD as compared to
those with PD+D who had a marked reduction in HRV. An orthostatic test in both patients with LBD and those with PD (mainly that with
dementia) showed inadequate sympathetic effects on heart rhythm, which is suggestive of cardiac sympathetic dysregulation and favors the
development of orthostatic hypotension. During the orthostatic test, the patients with LBD were found to have supraventricular premature
contractions with the pulse being fixed, which were probably caused by the hypersensitivity of denervated receptors to humoral factors. As the
denervation process became longer, receptor sensitivity was decreased, hence supraventricular premature beats and arterial hypertension
were absent in the horizontal position in long ill patients with PD+D, in whom the adaptive properties were considerably lower.
About the Authors
I G TishkovaIrina Sergeevna Preobrazhenskaya
I G Tishkova
Irina Sergeyevna Preobrazhenskaya
References
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For citation:
Tishkova I.G., Preobrazhenskaya I.S., Tishkova I.G., Preobrazhenskaya I.S. Heart rhythm variability analysis in patients with Levy body dementiaand in those with Parkinson's disease. Neurology, Neuropsychiatry, Psychosomatics. 2011;3(1):46-51. (In Russ.) https://doi.org/10.14412/2074-2711-2011-134
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