Abstract
The presence of postganglionic sympathetic denervation is well established in Parkinson’s disease (PD). Denervation at cardiac and blood vessel sites may lead to abnormal cardiovascular and hemodynamic responses to exercise. The aim of the present investigation was to examine how heart rate (HR) and hemodynamics are affected by an exercise test in PD patients without orthostatic hypotension. Thirty individuals without orthostatic hypotension, 14 individuals with PD, and 16 age-matched healthy controls performed an exercise test on a cycle ergometer. Heart rate, blood pressure, and other hemodynamic variables were measured in a fasted state during supine rest, active standing, exercise, and supine recovery. Peak HR and percent of age-predicted maximum HR (HRmax) achieved were significantly blunted in PD (p < 0.05, p < 0.01). HR remained significantly elevated in PD during recovery compared with controls (p = 0.03, p < 0.05). Systolic, diastolic, and mean arterial pressures were significantly lower at multiple time-points during active standing in PD compared with controls. Systemic vascular resistance index (SVRI) decreased significantly at the onset of exercise in PD, and remained significantly lower during exercise and the first minute of supine recovery. End diastolic volume index (EDVI) was significantly lower in PD during supine rest and recovery. Our results indicate for the first time that normal hemodynamics are disrupted during orthostatic stress and exercise in PD. Despite significant differences in EDVI at rest and during recovery, and SVRI during exercise, cardiac index was unaffected. Our finding of significantly blunted HRmax and HR recovery in PD patients has substantial implications for exercise prescription and recovery guidelines.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 751-758 |
| Number of pages | 8 |
| Journal | Applied Physiology, Nutrition and Metabolism |
| Volume | 44 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Blood pressure
- Dysautonomia
- Exercise
- Exercise test
- Heart rate
- Hemodynamics
- Parkinson’s disease
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Physiology
- Nutrition and Dietetics
- Physiology (medical)
Cite this
Hemodynamic responses to an exercise stress test in Parkinson’s disease patients without orthostatic hypotension. / Roberson, Kirk B.; Signorile, Joseph; Singer, Carlos; Jacobs, Kevin; Eltoukhy, Moataz Mohamed; Ruta, Nicolette; Mazzei, Nicolle; Buskard, Andrew N.L.
In: Applied Physiology, Nutrition and Metabolism, Vol. 44, No. 7, 01.01.2019, p. 751-758.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hemodynamic responses to an exercise stress test in Parkinson’s disease patients without orthostatic hypotension
AU - Roberson, Kirk B.
AU - Signorile, Joseph
AU - Singer, Carlos
AU - Jacobs, Kevin
AU - Eltoukhy, Moataz Mohamed
AU - Ruta, Nicolette
AU - Mazzei, Nicolle
AU - Buskard, Andrew N.L.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - The presence of postganglionic sympathetic denervation is well established in Parkinson’s disease (PD). Denervation at cardiac and blood vessel sites may lead to abnormal cardiovascular and hemodynamic responses to exercise. The aim of the present investigation was to examine how heart rate (HR) and hemodynamics are affected by an exercise test in PD patients without orthostatic hypotension. Thirty individuals without orthostatic hypotension, 14 individuals with PD, and 16 age-matched healthy controls performed an exercise test on a cycle ergometer. Heart rate, blood pressure, and other hemodynamic variables were measured in a fasted state during supine rest, active standing, exercise, and supine recovery. Peak HR and percent of age-predicted maximum HR (HRmax) achieved were significantly blunted in PD (p < 0.05, p < 0.01). HR remained significantly elevated in PD during recovery compared with controls (p = 0.03, p < 0.05). Systolic, diastolic, and mean arterial pressures were significantly lower at multiple time-points during active standing in PD compared with controls. Systemic vascular resistance index (SVRI) decreased significantly at the onset of exercise in PD, and remained significantly lower during exercise and the first minute of supine recovery. End diastolic volume index (EDVI) was significantly lower in PD during supine rest and recovery. Our results indicate for the first time that normal hemodynamics are disrupted during orthostatic stress and exercise in PD. Despite significant differences in EDVI at rest and during recovery, and SVRI during exercise, cardiac index was unaffected. Our finding of significantly blunted HRmax and HR recovery in PD patients has substantial implications for exercise prescription and recovery guidelines.
AB - The presence of postganglionic sympathetic denervation is well established in Parkinson’s disease (PD). Denervation at cardiac and blood vessel sites may lead to abnormal cardiovascular and hemodynamic responses to exercise. The aim of the present investigation was to examine how heart rate (HR) and hemodynamics are affected by an exercise test in PD patients without orthostatic hypotension. Thirty individuals without orthostatic hypotension, 14 individuals with PD, and 16 age-matched healthy controls performed an exercise test on a cycle ergometer. Heart rate, blood pressure, and other hemodynamic variables were measured in a fasted state during supine rest, active standing, exercise, and supine recovery. Peak HR and percent of age-predicted maximum HR (HRmax) achieved were significantly blunted in PD (p < 0.05, p < 0.01). HR remained significantly elevated in PD during recovery compared with controls (p = 0.03, p < 0.05). Systolic, diastolic, and mean arterial pressures were significantly lower at multiple time-points during active standing in PD compared with controls. Systemic vascular resistance index (SVRI) decreased significantly at the onset of exercise in PD, and remained significantly lower during exercise and the first minute of supine recovery. End diastolic volume index (EDVI) was significantly lower in PD during supine rest and recovery. Our results indicate for the first time that normal hemodynamics are disrupted during orthostatic stress and exercise in PD. Despite significant differences in EDVI at rest and during recovery, and SVRI during exercise, cardiac index was unaffected. Our finding of significantly blunted HRmax and HR recovery in PD patients has substantial implications for exercise prescription and recovery guidelines.
KW - Blood pressure
KW - Dysautonomia
KW - Exercise
KW - Exercise test
KW - Heart rate
KW - Hemodynamics
KW - Parkinson’s disease
UR - http://www.scopus.com/inward/record.url?scp=85068121463&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068121463&partnerID=8YFLogxK
U2 - 10.1139/apnm-2018-0638
DO - 10.1139/apnm-2018-0638
M3 - Article
VL - 44
SP - 751
EP - 758
JO - Applied Physiology, Nutrition and Metabolism
JF - Applied Physiology, Nutrition and Metabolism
SN - 1715-5312
IS - 7
ER -