Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes

Abstract Reduced uptake of 123I-meta-iodobenzylguanidine (123I-MIBG) and orthostatic hypotension (OH) are independently associated with worse clinical outcomes of Parkinson’s disease (PD). However, their interactive influence on PD has not been studied. The role of 123I-MIBG myocardial uptake, as a...

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Autores principales:	Sang-Won Yoo, Joong-Seok Kim, Yoon-Sang Oh, Dong-Woo Ryu, Seunggyun Ha, Ji-Yeon Yoo, Kwang-Soo Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/09778a11d2cf4dd1b654aa68f1add2f5
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spelling	oai:doaj.org-article:09778a11d2cf4dd1b654aa68f1add2f52021-12-02T16:27:55ZCardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes10.1038/s41531-021-00217-32373-8057https://doaj.org/article/09778a11d2cf4dd1b654aa68f1add2f52021-08-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00217-3https://doaj.org/toc/2373-8057Abstract Reduced uptake of 123I-meta-iodobenzylguanidine (123I-MIBG) and orthostatic hypotension (OH) are independently associated with worse clinical outcomes of Parkinson’s disease (PD). However, their interactive influence on PD has not been studied. The role of 123I-MIBG myocardial uptake, as a biomarker of PD severity, was investigated, conditional on the mediating effects of OH. A total of 227 PD patients were enrolled. Their motor and nonmotor aspects were assessed with standardized tools. Global disease burden was estimated by averaging the scaled z-scores of the assessment tools. Every patient went through 123I-MIBG scan, and OH was evaluated with the head-up tilt-test. The mediating role of orthostatic blood pressure changes (ΔBP) on the association between cardiac sympathetic denervation and disease burden was investigated. Low heart-to-mediastinum (H/M) ratio with less than 1.78 was seen in 69.6% of the patient population, and 22.9% of patients had OH. Low H/M ratio was associated with OH, and these patients had worse disease burden than subjects with normal 123I-MIBG uptake (global composite z-score: normal 123I-MIBG vs. abnormal 123I-MIBG; −0.3 ± 0.5 vs. 0.1 ± 0.7; p < 0.001). The mediation models, controlled for age and disease duration, revealed that the delayed H/M ratio and global composite score were negatively associated, irrespective of orthostatic ΔBP. Adverse relationship between cardiac sympathetic denervation and disease burden was shown without any interference from orthostatic blood pressure fluctuations. This result suggested that extracranial cardiac markers might reflect disease burden, regardless of labile blood pressure influence.Sang-Won YooJoong-Seok KimYoon-Sang OhDong-Woo RyuSeunggyun HaJi-Yeon YooKwang-Soo LeeNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Sang-Won Yoo Joong-Seok Kim Yoon-Sang Oh Dong-Woo Ryu Seunggyun Ha Ji-Yeon Yoo Kwang-Soo Lee Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
description	Abstract Reduced uptake of 123I-meta-iodobenzylguanidine (123I-MIBG) and orthostatic hypotension (OH) are independently associated with worse clinical outcomes of Parkinson’s disease (PD). However, their interactive influence on PD has not been studied. The role of 123I-MIBG myocardial uptake, as a biomarker of PD severity, was investigated, conditional on the mediating effects of OH. A total of 227 PD patients were enrolled. Their motor and nonmotor aspects were assessed with standardized tools. Global disease burden was estimated by averaging the scaled z-scores of the assessment tools. Every patient went through 123I-MIBG scan, and OH was evaluated with the head-up tilt-test. The mediating role of orthostatic blood pressure changes (ΔBP) on the association between cardiac sympathetic denervation and disease burden was investigated. Low heart-to-mediastinum (H/M) ratio with less than 1.78 was seen in 69.6% of the patient population, and 22.9% of patients had OH. Low H/M ratio was associated with OH, and these patients had worse disease burden than subjects with normal 123I-MIBG uptake (global composite z-score: normal 123I-MIBG vs. abnormal 123I-MIBG; −0.3 ± 0.5 vs. 0.1 ± 0.7; p < 0.001). The mediation models, controlled for age and disease duration, revealed that the delayed H/M ratio and global composite score were negatively associated, irrespective of orthostatic ΔBP. Adverse relationship between cardiac sympathetic denervation and disease burden was shown without any interference from orthostatic blood pressure fluctuations. This result suggested that extracranial cardiac markers might reflect disease burden, regardless of labile blood pressure influence.
format	article
author	Sang-Won Yoo Joong-Seok Kim Yoon-Sang Oh Dong-Woo Ryu Seunggyun Ha Ji-Yeon Yoo Kwang-Soo Lee
author_facet	Sang-Won Yoo Joong-Seok Kim Yoon-Sang Oh Dong-Woo Ryu Seunggyun Ha Ji-Yeon Yoo Kwang-Soo Lee
author_sort	Sang-Won Yoo
title	Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
title_short	Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
title_full	Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
title_fullStr	Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
title_full_unstemmed	Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes
title_sort	cardiac sympathetic burden reflects parkinson disease burden, regardless of high or low orthostatic blood pressure changes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/09778a11d2cf4dd1b654aa68f1add2f5
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_version_	1718383974521241600

Cardiac sympathetic burden reflects Parkinson disease burden, regardless of high or low orthostatic blood pressure changes

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