Document Detail


Abnormalities of rate-corrected QT intervals in Parkinson's disease-a comparison with multiple system atrophy and progressive supranuclear palsy.
MedLine Citation:
PMID:  12084439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kazushi Deguchi; Iwao Sasaki; Masago Tsukaguchi; Masashi Kamoda; Tetsuo Touge; Hiroaki Takeuchi; Shigeki Kuriyama
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  199     ISSN:  0022-510X     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-26     Completed Date:  2002-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  31-7     Citation Subset:  IM    
Affiliation:
Third Department of Internal Medicine, Kagawa Medical University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Autonomic Nervous System / physiopathology
Autonomic Nervous System Diseases / complications,  diagnosis*,  physiopathology
Blood Pressure
Electrocardiography
Female
Heart Function Tests
Heart Rate
Humans
Hypotension, Orthostatic / complications,  diagnosis,  physiopathology
Long QT Syndrome / complications,  diagnosis*,  physiopathology
Male
Middle Aged
Multiple System Atrophy / complications,  physiopathology*
Parkinson Disease / complications,  physiopathology*
Reference Values
Reflex, Abnormal
Supranuclear Palsy, Progressive / physiopathology*
Valsalva Maneuver

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