Left ventricular (LV) function was continuously monitored using a radionuclide detector (VEST) after intravenous injection of 25 mCi technetium- 99m labelled red blood cells in nine patients with Parkinson's disease and postural hypotension (group 1) and ten patients with Parkinson's disease but without postural hypotension (group 2). LV function and blood pressure were monitored in the supine position for 15 min (period A), upon changing posture from the supine to the upright position for 10 rain (period B), and upon returning to the supine position for 10 rain (period C). In group 1, the passage from period A to period B induced a significant decrease in end-diastolic volume, endsystolic volume and ejection fraction (all P<0.01). In group2, ejection fraction increased (P<0.05) upon changing posture from the supine to the upright position. Ejection fraction (F=33, P<0.01), end-diastolic volume (F=9, P<0.05) and end-systolic volume (F=10, P<0.05) were significantly different between the two groups. In group 1, stroke volume, cardiac output and vascular peripheral resistance decreased from period A to period B (all P<0.001). In group2, no changes in stroke volume, cardiac output and vascular peripheral resistance were observed from period A to period B. All parameters were similar in the two groups during the periods A and C. Upon changing posture from the supine to the upright position, patients with Parkinson's disease and postural hypotension showed marked changes in parameters of LV function induced by vascular abnormalities. The results of this study may help to clarify the potential risk of sudden postural changes in such patients, which may cause fainting, syncope and increased risk of ischaemic coronary and cerebrovascular attacks and of lower limb fractures.

Ambulatory Monitoring of Left Ventricular Function in Patients with Parkinson's Disease and Postural Hypotension

PACE, Leonardo;
1994

Abstract

Left ventricular (LV) function was continuously monitored using a radionuclide detector (VEST) after intravenous injection of 25 mCi technetium- 99m labelled red blood cells in nine patients with Parkinson's disease and postural hypotension (group 1) and ten patients with Parkinson's disease but without postural hypotension (group 2). LV function and blood pressure were monitored in the supine position for 15 min (period A), upon changing posture from the supine to the upright position for 10 rain (period B), and upon returning to the supine position for 10 rain (period C). In group 1, the passage from period A to period B induced a significant decrease in end-diastolic volume, endsystolic volume and ejection fraction (all P<0.01). In group2, ejection fraction increased (P<0.05) upon changing posture from the supine to the upright position. Ejection fraction (F=33, P<0.01), end-diastolic volume (F=9, P<0.05) and end-systolic volume (F=10, P<0.05) were significantly different between the two groups. In group 1, stroke volume, cardiac output and vascular peripheral resistance decreased from period A to period B (all P<0.001). In group2, no changes in stroke volume, cardiac output and vascular peripheral resistance were observed from period A to period B. All parameters were similar in the two groups during the periods A and C. Upon changing posture from the supine to the upright position, patients with Parkinson's disease and postural hypotension showed marked changes in parameters of LV function induced by vascular abnormalities. The results of this study may help to clarify the potential risk of sudden postural changes in such patients, which may cause fainting, syncope and increased risk of ischaemic coronary and cerebrovascular attacks and of lower limb fractures.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11386/3104805
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