Correlation Between Systolic Blood Pressure Variability and Global Longitudinal Strain in Patients with Parkinson's Disease and Dysautonomia

Background: Patients with Parkinson’s disease (PD) and dysautonomia often present elevated blood pressure (BP) variability. However if the elevate BP variability is correlated with subclinical echocardiography abnormalities have been poorly investigated yet. Our aim was to evaluate the correlation between indices of left ventricular function and 24/h BP variability in patients with PD. Methods: We studied 21 patients with diagnosed PD and autonomic dysfunction and 20 hypertensive age-matched subjects. All patients underwent 24/h ambulatory blood pressure monitoring (ABPM) and echocardiography. Left ventricular (LV) systolic function was evaluated by ejection fraction (EF), tissue Doppler s wave and global longitudinal strain (GLS). BP variability was evaluated through average real variability. Results: At ABPM, patients with PD had an higher occurrence of nocturnal hypertension, orthostatic hypotension and post-prandial hypotension compared to hypertensive subjects. GLS, tissue Doppler s velocity, LVEF, LV mass index, and E/e’ ratio were similar between the patients with PD and those with hypertension. In patients with PD there was a significant correlation between GLS and 24/h systolic BP variability (r= 0.44; p=0.01). a trend through significance between 24 systolic BP variability and tissue Doppler s velocity (r= -0.31; p=0.06). Conclusions: In PD patients, short-term BP variability was inversely related to GLS. GLS seems to be an early detector of LV dysfunction in patients with PD and autonomic dysfunction.