Objective: The study focuses on assessing cardiovascular autonomic dysfunction in patients with different atypical Parkinsonian syndromes compared to healthy controls using the heart rate deceleration capacity.

Background: Autonomic dysfunction is a common symptom in patients presenting with Parkinsonian syndromes and has significant implications for diagnosis and therapy. In multiple system atrophy (MSA) autonomic failure is a characteristic feature, whereas it has been considered as a rather exclusionary feature in the diagnosis of progressive supranuclear palsy (PSP). As for patients after myocardial infarction an increased cardiovascular mortality has been shown in patients with different Parkinsonian syndromes. In patients after myocardial infarction an impaired heart rate deceleration capacity serves as an indicator for cardiovascular autonomic dysfunction and predictor of mortality.

Methods: We quantified the heart rate deceleration capacity by assessing Holter recordings of 10 patients with MSA and 9 patients with PSP in comparison with a group of 10 healthy controls. Holter recording (Getemed, CardioMem®, CM3000SMA) was performed for a 30 min period with the patient in a supine position in a quiet, shaded room. Patients with a medical history of heart disease have been excluded, also any medication affecting the autonomic nervous system was not allowed.

Results: 1. Deceleration capacity of heart rate was significantly impaired in patients with MSA compared to the control group. 2. Deceleration capacity was also significantly impaired in patients with PSP indicating cardiovascular autonomic dysfunction in these patients.

Conclusions: Cardiovascular autonomic dysfunction is not only present in patients with MSA, but also in subjects with PSP. Therefore, autonomic testing should be part of the diagnostic procedure as well as clinical follow-up in these patients. These findings may have an impact on diagnosis and therapy of patients with PSP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deceleration-capacity-of-heart-rate-indicates-autonomic-dysfunction-in-patients-with-psp/