Analysis Of Cardiovascular Risk In Patients With Parkinson's Disease Under Levodopa Treatment

BackgroundParkinson's disease(PD)is the second most common neurodegenerative disease after Alzheimer's disease in the elderly,characterized by its typical dyskinesia.Since the incidence of PD is age-dependent,as our country gradually into the aging society,the number of PD patients will gradually increase,which will become a concern of social problems.Levodopa is the indispensable choice of medial therapy in patients with PD.Since L-dopa treatment was shown to increase serum homocysteine levels,a well-known risk factor for cardiovascular disorders,and the patients with PD under L-dopa treatment will be at increased risk for future cardiovascular events.In order to validate our inference,this study was intended to evaluate changes in homocysteine levels and cardiovascular risk factors in patients with levodopa and non-treated PD patients.ObjectiveThe levels of homocysteine in the blood of patients with PD under levodopa treatment and control were measured to verify whether long-term treatment of levodopa could cause homocysteine levels rise.The parameters of cardiovascular risk factors were evaluated by echocardiography to verify whether long-term treatment of levodop will make patients under cardiovascular risk.MethodsThe study population consisted of 53 PD patients who take levodopa treatment for more than one year and the control group included 43 PD patients without levodopa treatment.All of them registered at Neurology of Shandong Provincial Hospital between January 2014 and December 2016.All the patients with coronary heart disease,hypertension,diabetes,congenital heart disease,heart failure,chronic obstructive pulmonary disease,atrial fibrillation,pacemaker implantation,rheumatic valvular disease,heart valve replacement were excluded from the study.ResultsCompared with the control,the levels of homocysteine in patients with PD under levodopa treatment were significantly increased(11.79± 3.65 and 15.38 ± 5.43;P<0.001).In addition,the early mitral diastolic velocity(E peak,cm/s)was significantly reduced(82.64 ± 13.87 and 66.43 ±9.86;P?0.002)and the ratio of E/A was significantly decreased(1.02±0.26 and 0.82±0.19;P=0.034)in PD patients treated with levodopa when compared to untreated patients.T.We also found that there was a negative correlation between homocysteine levels and E peak(r=-0.551,p<0.01)and E/A(r=-0.549,p<0.01),indicating that levodopa may influence early diastolic function of the heart by increased homocysteine.ConclusionsThe prensent study found that the plasma homocysteine levels were significantly increased in the patients with PD under long-term levodopa treatment,and early mitral valve diastolic velocity decreased significantly in these patients by echocardiography,indicating that the patient's heart function is to some extent influenced.In addition,our data also found that the level of homocysteine and E peak and E/A ratio was negatively correlated,indicating that levodopa may influence early diastolic function of the heart by increased homocysteine.Therefore,patients under long-term levodopa may be at risk of developing cardiovascular disease.