| Autor: |
Roberson KB; a Laboratory of Neuromuscular Research & Active Aging, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA., Signorile JF; a Laboratory of Neuromuscular Research & Active Aging, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA.; b Center on Aging, Miller School of Medicine, University of Miami, Miami, FL 33136, USA., Singer C; c Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.; d Director, Division of Parkinson's Disease and Movement Disorders, Miami, FL 33136, USA., Jacobs KA; e Laboratory of Clinical and Applied Physiology, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA., Eltoukhy M; f Sports Medicine and Motion Analysis Laboratory, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA., Ruta N; a Laboratory of Neuromuscular Research & Active Aging, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA., Mazzei N; a Laboratory of Neuromuscular Research & Active Aging, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA., Buskard ANL; a Laboratory of Neuromuscular Research & Active Aging, Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA. |
| Abstrakt: |
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 (HR max ) 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 HR max and HR recovery in PD patients has substantial implications for exercise prescription and recovery guidelines. |
