Abnormalities of rate-corrected QT intervals in Parkinson's disease - a comparison with multiple system atrophy and progressive supranuclear palsy
Abnormalities of rate-corrected QT intervals in Parkinson's disease - a comparison with multiple system atrophy and progressive supranuclear palsy
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DOI：
10.1016/s0022-510x(02)00079-5
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发表时间：
2002-07-15
影响因子：
4.4
通讯作者：
Kuriyama, S
中科院分区：
文献类型：
--
作者：
Deguchi, K;Sasaki, I;Kuriyama, S
许多帕金森病（PD）和多系统萎缩（MSA）患者偶尔会发生猝死，心电图（ECG）显示QT或心率校正QT（QTc）间期延长。尽管这些QT或QTc间期异常可能与自主神经功能障碍有关，但其病理生理学仍不清楚。本研究的目的是比较运动不能僵硬综合征（PD）和相关疾病之间QTc间期延长的程度，并评估QTc间期延长与自主神经功能障碍严重程度之间的关系。34例PD患者、22例MSA患者、11例进行性核上性麻痹（PSP）患者和30例健康对照者接受标准自主神经功能测试，并通过ECG记录仪和自动分析仪测量心电图变量（RR、QT和QTc间期）。分析QTc间期与心血管反射试验的关系。直立性低血压和呼吸刺激引起的心率下降在MSA中很突出，而在PD中相对较轻。与RR和QT间期不同，所有组之间的QTc间期存在显着差异（p < 0.01）。与健康对照组（394 +/-19 ms）相比，PD组（409 +/- 17 ms; p < 0.001）和MSA组（404 +/- 14 ms; p < 0.05）的QTc间期显著延长。PSP患者的自主神经功能障碍和QTc间期延长均不明显。QTc间期和心血管反射没有相关性，除了Valsalva比率。PD患者的QTc间期明显延长，其程度不能简单地用自主神经功能障碍水平来解释。MSA患者尽管有明显的心血管自主神经功能障碍，但QTc间期略有延长。QTc间期的缩短可能反映了心血管自主神经功能测试无法完全捕获的心选择性交感神经和副交感神经元的变性。(C)2002 Elsevier Science B. V.保留所有权利。
A number of patients with Parkinson's disease (PD) and multiple system atrophy (MSA), in whom sudden death does occur occasionally, have QT or rate-corrected QT (QTc) interval prolongation on electrocardiogram (ECG). Although these QT or QTc interval abnormalities are likely related to autonomic dysfunction, the pathophysiology remains unknown. The aim of this study was to compare the degree of QTc interval prolongation among akinetic-rigid syndromes, namely PD and related disorders, and to evaluate the relationship between QTc prolongation and severity of autonomic dysfunction. Thirty-four patients with PD, 22 with MSA, 11 with progressive supranuclear palsy (PSP) and 30 healthy controls underwent standard autonomic function tests, and electrocardiography variables (RR, QT and QTc intervals) were measured by an ECG recorder with an automated analyzer. The relationship between QTc interval and cardiovascular reflex tests were also analyzed. Orthostatic hypotension and decreased heart rate in response to respiratory stimuli were prominent in MSA, while these were relatively mild in PD. Unlike the RR and QT intervals, the QTc interval significantly differed among all groups (p < 0.01). The QTc interval was significantly prolonged in PD (409 +/- 17 ms; p < 0.001) and MSA (404 +/- 14 ms; p < 0.05) compared with healthy controls (394 +/- 19 ms). Neither autonomic dysfunction nor QTc interval prolongation was evident in PSP. QTc intervals and cardiovascular reflexes did not correlate, except for Valsalva ratio. The QTc interval was obviously prolonged in PD patients to an extent that could not be accounted for simply by autonomic dysfunction levels. MSA patients showed slightly prolonged QTc intervals in spite of marked cardiovascular autonomic dysfunction. Abnormalities of the QTc may reflect the degeneration of cardioselective sympathetic and parasympathetic neurons that cannot be fully Captured by cardiovascular autonomic function tests. (C) 2002 Elsevier Science B.V. All rights reserved.