Relative Dilatation of Left Ventricle and Left Atrium in Patients with Parkinson Disease

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This study was supported by Czech Health Research Council AZV NU21-04-00445 and by the European Regional Development Fund - project ENOCH (No. CZ.02.1.01/0.0/0.0/16_019/0000868) Introduction Morbus Parkinson (MP) is the second most common neurodegenerative disease that progressively affects the nervous system. Accompanying heart problems may include mainly cardiovascular autonomic dysfunction. So far, very little is known about structural and functional cardiac changes in patients with MP. Purpose This pilot study aimed to analyse left ventricular (LV) and left atrial (LA) function and volumes using cardiovascular magnetic resonance (CMR). Methods In this study, 37 patients with MP (mean age 59,0 ± 8,0 years) without a history of cardiac disease or symptoms were compared to 37 sex- and age-matched control subjects without any heart disease history (mean age 54,5 ± 11,4 years). All patients underwent CMR examination at 1,5 MR scanner, including cine images for assessment of LV and LA volumetric and functional parameters. LA volumes (LAV) were measured at LV end-systole (maximum LAV - LAVmax), before the atrial contraction (pre-atrial contraction volume - LAVpac), and at late LV diastole (minimum LAV - LAVmin) and indexed (I) to the body surface area. LA strains were analysed for all LA phases: reservoir strain (LSr), conduit strain (LScd), and contractile strain (LSct). Descriptive statistics are reported as the mean (SD) or median (IQR) for normally and non-normally distributed continuous variables. All the p-values were adjusted using a false discovery rate for multiple comparisons. Results MP patients had normal global and regional systolic LV function – LV ejection fraction (EF) 65,9 ± 6,8% vs 68,9 ± 7,0% (p = NS). On the contrary, all indexed LV volumes were significantly higher in comparison to controls: LV end-diastolic volume index was 67,3 ± 12,1 ml/m2 vs 58,3 ± 11,7 ml/m2 (p = 0,013), LV end-systolic volume index was 22,0 (17,8 to 27,5) ml/m2 vs 18,9 (13,2 to 21,9) ml/m2 (p = 0,027), and LV stroke volume index was 43,8 ± 7,2 ml/m2 vs 39,8 ± 6,3 ml/m2 (p = 0,035). Similarly, indexed LAVmax and LAVpac were also relatively increased: LAVImax 42,7 ± 9,0 ml/m2 vs 35,7 ± 10,3 ml/m2 (p = 0,014), LAVIpac 29,8 ± 7,1 vs 23,8 ± 7,6 ml/m2 (p = 0,012). LAVImin was similar in both groups: 17,3 ± 5,5 ml/m2 vs 14,3 ± 6,7 ml/m2 (p = NS). LA strains were slightly lower in the MP cohort during the reservoir and conduit phase, and slightly higher in the contractile one. However, the difference did not reach statistical significance in any phase. Conclusion Patients with Parkinson´s disease have enlarged LV and LA compared to controls.