Alteraciones de la estructura y función cardiaca en pacientes con enfermedad de parkinson. Estudio con ecocardiografía y grupo control
- Autores: Jesús Piqueras Flores
- Directores de la Tesis: Julia Vaamonde Gamo (dir. tes.), Álvaro L. Moreno Reig (codir. tes.)
- Lectura: En la Universidad de Castilla-La Mancha ( España ) en 2016
- Idioma: español
- Tribunal Calificador de la Tesis: Alino José Martínez Marcos (presid.), Amalia Hernández González (secret.), Martín Ruiz Ortiz (voc.)
- Programa de doctorado: Programa de Doctorado en Ciencias de la Salud por la Universidad de Castilla-La Mancha
- Materias:
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- Resumen
Abstract:
Background: Parkinson’s disease (PD) patients have most frequentlyheart failure regardless of the existence of cardiomyopathies or cardiovascular risk factors. However, the cause of this increased prevalence is not known. There are several pathophysiological hypotheses but they have not been studied in clinical practice. Thus, we designed a study to assess the cardiac function and structure in patients with PD compared with a control group.
Methods: Cross-sectional study with 50 PD patients and 50 healthy matched controls. We excluded patients with known cardiopathy and valvular disease. We performed electroand echocardiograms to all patients and the measurements were blind. In addition, we performed a neurological assessment of patients with PD.
Results: PD patients had higher left ventricular mass index (114.2± 38.4 g / m2 vs 94.1 ± 26.4 g / m2; p = 0.003), higher left atrial volumen (30.1 ± 7.9 ml/m2 vs 26.7 ± 6.2 ml/m2; p=0.01) and E / E' ratio (9.6 ± 3.1 vs 7.8 ± 1.7; p=0.001).They, also presented worse NYHA functional class due to diastolic dysfunction and the PD was an independent risk factor for elevated left ventricular filling pressures (OR=2.7, CI 95% 2.2-6.3; p=0.004). Concentric remodelling and left ventricular hypertrophy was associated with more advanced Hoehn and Yahr stages.
Conclusions: Parkinson's disease is significantly associated with increased concentric left ventricular hypertrophy, atrial volume and diastolic dysfunction. Advanced stages of PDare associated with a more severe cardiac affection. Thesefindings can explain the increase of heart failure in PDpatients.
