Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease.

Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease. Research Abstract Details 

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Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease. Abstract Text:

Tomohiko Nakamura,Masaaki Hirayama,Hiroki Ito,Motoko Takamori,Kensuke Hamada,Shigeo Takeuchi,Hirohisa Watanabe,Yasuo Koike,Gen Sobue,Tomohiko Nakamura,Masaaki Hirayama,Hiroki Ito,Motoko Takamori,Kensuke Hamada,Shigeo Takeuchi,Hirohisa Watanabe,Yasuo Koike,Gen Sobue,Tomohiko Nakamura,Masaaki Hirayama,Hiroki Ito,Motoko Takamori,Kensuke Hamada,Shigeo Takeuchi,Hirohisa Watanabe,Yasuo Koike,Gen Sobue,

OBJECTIVE: Cardiac uptake of [(123)I]metaiodobenzyl guanidine (MIBG) is reduced in patients with Parkinson's disease (PD). However, the cardiac sympathetic abnormality associated with this reduction is unclear. To unmask this abnormality in PD patients we examined the functional consequences of cardiac beta-receptor activation. METHODS: Cardiovascular responses to stepwise administration of the beta1-receptor agonist, dobutamine (DOB), were assessed in 25 PD patients and 12 age-matched controls. Changes in blood pressure were compared to determine the optimal dose at which to detect denervation supersensitivity, and cardiac contractility was measured by DOB echocardiography, based on peak aortic flow velocity. The relations of these cardiovascular responses to the ratio of MIBG uptake into the heart vs. that into the mediastinum (H/M ratio) were analyzed. RESULTS: At 4 mug/kg/min DOB, systolic blood pressure increased more in PD patients than in controls (PD, 17.5+/-12.3 mm Hg; control, 7.2+/-6.2 mm Hg, p<0.01), suggesting the presence of denervation supersensitivity. At this DOB dose cardiac contractility also increased more in PD than in controls (PD, 39.0+/-15.7%; control, 23.5+/-5.2%, p<0.005) and this hyperdynamic response was significantly correlated with reduced H/M ratios (early: r=-0.63, p<0.01, delayed: r=-0.66, p<0.01). CONCLUSION: Low-dose DOB unmasks cardiac sympathetic denervation in PD patients, and decreased MIBG uptake indicates the presence of denervation supersensitivity within the heart, resulting in hyperdynamic cardiac contractility in response to a beta 1-stress condition.

Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease. Publishing Authors By Initials

T Nakamura,M Hirayama,H Ito,M Takamori,K Hamada,S Takeuchi,H Watanabe,Y Koike,G Sobue,T Nakamura,M Hirayama,H Ito,M Takamori,K Hamada,S Takeuchi,H Watanabe,Y Koike,G Sobue,T Nakamura,M Hirayama,H Ito,M Takamori,K Hamada,S Takeuchi,H Watanabe,Y Koike,G Sobue,

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Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of the neurological sciences

VOLUME: 263

Page Numbers: 133-8

Journal Abbreviation: J. Neurol. Sci.

ISSN: 0022-510X

DAY: 1

MONTH: 08

YEAR: 2007

Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease. Information

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LANGUAGE: eng

NlmUniqueID: 375403

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Grant and Affiliation Information for Dobutamine stress test unmasks cardiac sympathetic denervation in Parkinson's disease.

AFFILIATION: Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

Country: Netherlands

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MEDLINETA: J Neurol Sci

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