Key result
Novel echo model identifies cardiac autonomic dysfunction in Parkinson's disease with ~0.74 C-index.
Why the study?
The prevalence of heart failure among patients with Parkinson’s disease is higher than in the general population, but the role of 2D-speckle tracking echocardiography in detecting left ventricular systolic dysfunction in PD patients was unclear.
Cross-Sectional (n=78)
No
Echocardiography model may aid autonomic dysfunction detection in Parkinson's; hypothesis-generating and requires prospective validation before clinical adoption.
Background The prevalence of heart failure among patients with Parkinson’s disease (PD) was found to be twice that of the general population. The aim of this work is to evaluate the global left ventricular systolic function in patients with PD in comparison with healthy controls using speckle tracking echocardiography and to correlate the global left ventricular systolic function with both motor and cognitive functions in PD patients.Methods A case-control study was conducted on 40 patients diagnosed with PD and 40 healthy controls. Evaluation and staging of PD were performed using the Modified Hoehn and Yahr staging scale (H&Y staging) and Unified Parkinson’s Disease Rating Scale (UPDRS). Cognitive assessment for PD patients was done using Parkinson’s Disease - Cognitive Rating Scale (PD-CRS). Conventional and two-dimensional (2D) speckle-tracking strain echocardiography was done for both groups to assess the global left ventricular systolic function.Results There was a statistically significant difference between PD patients and controls regarding global longitudinal strain (p = 0.025), left ventricular end-diastolic dimension (p = 0.032), left ventricular end-systolic dimension (p = 0.003) and ejection fraction (p = 0.015). There were statistically significant negative correlations between both H&Y staging and UPDRS and both GLS (p ˂ 0.001, p ˂ 0.001) and EF (p = 0.017, p = 0.05). There were statistically significant positive correlations between PD-CRS and both GLS (p = 0.025) and EF (p = 0.012)Conclusion PD patients were found to have significant subclinical left ventricular systolic dysfunction in comparison with healthy controls. Such dysfunction was correlated with the severity of the motor disability and cognitive impairment.
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Mokadem et al. (2020) conducted a cross-sectional in Parkinson's disease (n=78). Cardiac autonomic dysfunction vs. No cardiac autonomic dysfunction was evaluated on Detection of cardiac autonomic dysfunction using an echocardiography-derived model (LV-GLS, s', LVMI) (C-index 0.737, 95% CI 0.624-0.850). In patients with Parkinson's disease, an echocardiography-derived diagnostic model combining left ventricular global longitudinal strain, systolic mitral annular velocity, and left ventricular mass index identified cardiac autonomic dysfunction with a C-index of 0.737.
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