The Preliminary Study On The Relationship Between Cardiac Autonomic Dysfunction And Deceleration Capacity Of Rate,acceleration Capacity Of Rate In Chinese Patients With Parkinson's Disease

Objective: Parkinson's disease(PD)is a common neurodegenerative disease.Clinically,Parkinson's disease is difficult to cure,and cause great damage to patients,families and even the whole society.Early diagnosis and treatment are very important.The clinical diagnosis of Parkinson's disease depends on the screening of symptoms.Some clinical results showed that cardiac autonomic nerve dysfunction and other non motor symptoms can be used as a clinical phenotype of early Parkinson's disease,but the metaiodoenzylguanidine(MIBG)cardiac sympathetic nerve imaging method requires complex reagents and equipment.It is difficult to popularize in our country at present.Heart rate Viability is a Non dumping,easy manipulation,high sensitivity detection to detect the autonomic nervous function.However,some studies have shown that heart rate variability cannot distinguish between the sympathetic and parasympathetic nerve function.Deceleration of heart rate and acceleration of heart rate is a new method to evaluate autonomic nerve function by 24 hour heart rate trend analysis.Deceleration capacity of rate,acceleration capacity of rate can be respectively used to test the direct role of parasympathetic and sympathetic nerve on heart rate,meanwhile they exclude the indirect effects on the baroreceptor reflex,so they may become a convenient method for the detection of autonomic dysfunction in Parkinson's disease.Nevertheless,few studies have been conducted on the deceleration capacity of rate and acceleration capacity of rate in patients with Parkinson's disease.In our study,we compare the healthy people with patients with Parkinson's disease,we test the capacity of rate,acceleration capacity of rate,heart rate variability,to explore the use of these methods in the electrophysiology of cardiac autonomic dysfunction in patients with Parkinson's disease.Methods: Select patients with idiopathic Parkinson's disease visited neurology clinic in The first affiliated hospital of Fujian Medical University during December 2015 and February 2017,and choose health medical person from the healthy check-up department in the First Affiliated Hospital of Fujian Medical University during October 2012 and February 2017 to be the control group.Collect the following information: 1.General situation: including the social demographic data like name,gender and age of the patients,the disease duration,clinical manifestations,the existence of hyposmia,existence of illusion,drug history,the dosage,effectiveness,the use of levodopa agonist.2.The clinical data :including the application of MDS-UPDRS score,the revised Hoehn-Yahr staging assessment for the severity of Parkinson's disease,the orthostatic blood pressure of Parkinson's disease group,and heart rate detection of two groups,compare the differences of heart rate deceleration forces,acceleration force,heart rate variabilityn between two groups.Result:1.Parkinson's disease group: 43 patients with sex ratio of 25:18;including 25(58%)cases of man,18(42%)cases of women;aged 43~74 years old,average age(58.91±7.276)years old;duration 0.5~13 years;UPDRS score 4~59 points;H-Y stage 1~3,the average(1.95±0.653)period.The effective dose of levodopa was 0~1191.7mg,67.4% use dopamine agonists.In the control group: 27 cases were male,accounting for 60%,and the female was in the control group,accounting for 18,accounting for 40% cases.Age 25~75 years;mean age(56.47 + 12.114)years.There was no significant difference in age and gender between the two groups.2.there was no significant difference in the time domain parameters of heart rate variability(SDNN,r MSSD,p NN50)in the Parkinson's disease group compared with the control group.The heart rate variability(HRV)of the group was lower than that of the control group,and the difference was statistically significant(P<0.05)in the frequency domain parameters of heart rate variability(LF)than that in the control group(HF).There was no statistical difference in LF/HF.3.Parkinson's disease group deceleration capacity of rate,acceleration capacity of rate compared with the control group,the difference was statistically significant(P<0.001).4.the LF of Parkinson's disease group was related to the acceleration capacity of rate,the correlation coefficient was 0.723,P<0.001,the HF of the patients was related to the deceleration capacity of rate,the correlation coefficient was 0.453,P<0.01.5 age was negatively correlated with deceleration capacity of rate and acceleration capacity of rate.Conclusion: LF,HF,which are the frequency domain indexes of HRV,can detect cardiac autonomic dysfunction in patients with PD;the deceleration capacity of rate and the acceleration capacity of rate may be new cardiac autonomic nerve function tests for the patients with PD;age affects the deceleration capacity of rate and the acceleration capacity of rate in the patients with PD.