Haensch C et al. (2005) Beat-to-beat blood pressure analysis after premature ventricular contraction indicates sensitive baroreceptor dysfunction in Parkinson's disease. Mov Disord [doi: 10.1002/mds.20744]

A recent study in Germany investigated whether the analysis of beat-to-beat blood pressure in patients with Parkinson's disease (PD) could be used to accurately assess their sympathetic neurocirculatory function. PD is frequently associated with disturbed neurocirculatory innervation, resulting in baroreceptor dysfunction, impaired blood pressure regulation and orthostatic hypotension. Diagnosis of the impairment is problematic, however, because patients experience difficulties in performing standard cardiovascular autonomic tests.

Haensch and colleagues analyzed recordings of resting finger arterial pressure made continuously and noninvasively in 40 PD patients and 80 controls for 10 min, before the participants carried out a series of cardiovascular autonomic tests such as the Valsalva maneuver and tilt-table testing.

In 55% of patients with PD and 16% of controls at least one premature ventricular contraction (PVC) occurred during the recording (P <0.001). Of these, control subjects showed an increase in blood pressure in the first nine beats after the PVC, whereas the patients with PD had a blood pressure lower than baseline during postextrasystolic beats two to nine.

The authors suggest that the measurement of finger arterial pressure for assessing sympathetic neurocirculatory function in patients with PD is a highly sensitive test that does not require patient cooperation. They note, however, that the test requires a PVC to occur spontaneously, which appears to happen in only 55% of PD cases.