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Short-term deceleration capacity of heart rate: a sensitive marker of cardiac autonomic dysfunction in idiopathic Parkinson’s disease

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Abstract

Purpose

Cardiac autonomic dysfunction in idiopathic Parkinson’s disease (PD) manifests as reduced heart rate variability (HRV). In the present study, we explored the deceleration capacity of heart rate (DC) in patients with idiopathic PD, an advanced HRV marker that has proven clinical utility.

Methods

Standard and advanced HRV measures derived from 7-min electrocardiograms in 20 idiopathic PD patients and 27 healthy controls were analyzed. HRV measures were compared using regression analysis, controlling for age, sex, and mean heart rate.

Results

Significantly reduced HRV was found only in the subcohort of PD patients older than 60 years. Low- frequency power and global HRV measures were lower in patients than in controls, but standard beat-to-beat HRV markers (i.e., rMSSD and high-frequency power) were not significantly different between groups. DC was significantly reduced in the subcohort of PD patients older than 60 years compared to controls.

Conclusions

Deceleration-related oscillations of HRV were significantly reduced in the older PD patients compared to healthy controls, suggesting that short-term DC may be a sensitive marker of cardiac autonomic dysfunction in PD. DC may be complementary to traditional markers of short-term HRV for the evaluation of autonomic modulation in PD. Further study to examine the association between DC and cardiac adverse events in PD is needed to clarify the clinical relevance of DC in this population.

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Acknowledgements

This paper is dedicated to the memory of Professor Mario Estévez Báez, an outstanding scientist who devoted his life to human physiology research, through his extensive studies on the assessment of autonomic nervous system and methodological aspects of HRV analysis. The authors would like to thank all participants for their valuable contribution to this study. This work was facilitated by a travel grant awarded by the International Parkinson and Movement Disorder Society Pan American Section to CCN. The study was funded by a research grant awarded by The Michael J. Fox Foundation for Parkinson’s Research to CM and BS.

Funding

This work was supported by the Michael J. Fox Foundation for Parkinson’s Research [Grant Number MJFF 6896].

Author information

Authors and Affiliations

  1. Facultad de Biología, Universidad de La Habana, Havana, Cuba

    Claudia Carricarte Naranjo & Andrés Machado

  2. Edmond J Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada

    Connie Marras, Naomi P. Visanji & Anthony E. Lang

  3. Member of the National Coalition of Independent Scholars (NCIS), Battleboro, VT, USA

    David J. Cornforth

  4. Department of Radiology, University of Calgary, Calgary, AB, Canada

    Lazaro Sanchez‑Rodriguez

  5. Department of Pathology, Stanford School of Medicine, Stanford, CA, USA

    Birgitt Schüle

  6. Department of Neurology, University of California, San Francisco, CA, USA

    Samuel M. Goldman

  7. Departamento de Neurofisiología Clínica, Instituto de Neurología y Neurocirugía, La Habana, Cuba

    Mario Estévez

  8. School of Medicine, Washington University, St. Louis, MO, USA

    Phyllis K. Stein

  9. Khalifa University, Abu Dhabi, UAE

    Herbert F. Jelinek

Authors
  1. Claudia Carricarte Naranjo
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  2. Connie Marras
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  3. Naomi P. Visanji
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  4. David J. Cornforth
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  5. Lazaro Sanchez‑Rodriguez
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  6. Birgitt Schüle
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  7. Samuel M. Goldman
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  8. Mario Estévez
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  9. Phyllis K. Stein
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  10. Anthony E. Lang
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  11. Herbert F. Jelinek
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  12. Andrés Machado
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Corresponding author

Correspondence to Claudia Carricarte Naranjo.

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Conflict of interest

CM has received research grants from the Michael J. Fox Foundation, Canadian Institutes of Health Research, Parkinson’s Foundation (US), National Institutes of Health (US), and International Parkinson and Movement Disorders Society. She is a consultant for Grey Matter Technologies and receives financial compensation as a steering committee member from the Michael J. Fox Foundation. The remaining authors declare that they have no conflict of interest.

Ethical standards

The study protocol was approved by the University Health Network Research Ethics Board (Toronto) and El Camino Hospital Institutional Review Board (Parkinson’s Institute). The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All participants provided written informed consent prior to their inclusion in the study.

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Carricarte Naranjo, C., Marras, C., Visanji, N.P. et al. Short-term deceleration capacity of heart rate: a sensitive marker of cardiac autonomic dysfunction in idiopathic Parkinson’s disease. Clin Auton Res 31, 729–736 (2021). https://doi.org/10.1007/s10286-021-00815-4

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  • DOI: https://doi.org/10.1007/s10286-021-00815-4

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