Neurocardiovascular pathology in pre-manifest and early-stage Huntington's disease
Por:
Diago, EB, Perez-Perez, J, Lasaosa, SS, Alebesque, AV, Martinez-Horta, S, Kulisevsky, J, del Val, JL
Publicada:
1 jul 2018
Resumen:
Background and purposeCardiovascular events are a major cause of early death in the Huntington's disease (HD) population. Dysautonomia as well as deterioration of circadian rhythms can be detected early in the disease progression and can have profound effects on cardiac health. The aim of the present study was to determine if patients with HD and pre-manifest mutation carriers present a higher risk of cardiovascular disease than non-mutation-carrying controls.
MethodsThis was a prospective, cross-sectional, multicentre study of 38 HD mutation carriers (23 pre-manifest and 15 early-stage patients) compared with 38 age- and gender-matched healthy controls. Clinical and epidemiological variables, including the main haematological vascular risk factors, were recorded. Ambulatory blood-pressure monitoring and carotid intima-media thickness (CIMT) measurement were performed to assess autonomic function and as target-organ damage markers.
ResultsMost (63.2%) patients with HD (86.7% and 47.8%, respectively, of the early-stage and pre-manifest patients) were non-dippers compared with 23.7% of controls (P = 0.001). CIMT values were in the 75(th) percentile in 46.7% and 43.5%, respectively, of the early-stage and pre-manifest patients, whereas none of the controls presented pathological values (P = 0.001 and P = 0.006, respectively). Nocturnal non-dipping was significantly associated with CIMT values in patients (P = 0.002) but not in controls.
ConclusionsThese results suggest that higher cardiovascular risks and target-organ damage are present even in pre-manifest patients. Although larger studies are needed to confirm these findings, clinicians should consider these results in the cardiovascular management of patients with HD.
Filiaciones:
Diago, EB:
Hosp Clin Univ Lozano Blesa, Dept Neurol, San Juan Bosco 15, Zaragoza 50009, Spain
IIS Aragon, Res Grp Movement Disorders & Headache GIIS070, Zaragoza, Spain
Perez-Perez, J:
Hosp Santa Creu & Sant Pau, Dept Neurol, Movement Disorders Unit, Barcelona, Spain
IIB St Pau, Biomed Res Inst St Pau, Barcelona, Spain
CIBERNED, Ctr Invest Biomed Red Enfermedades Neurodegenerat, Barcelona, Spain
Lasaosa, SS:
Hosp Clin Univ Lozano Blesa, Dept Neurol, San Juan Bosco 15, Zaragoza 50009, Spain
IIS Aragon, Res Grp Movement Disorders & Headache GIIS070, Zaragoza, Spain
Alebesque, AV:
Hosp Clin Univ Lozano Blesa, Dept Neurol, San Juan Bosco 15, Zaragoza 50009, Spain
IIS Aragon, Res Grp Movement Disorders & Headache GIIS070, Zaragoza, Spain
Martinez-Horta, S:
Hosp Santa Creu & Sant Pau, Dept Neurol, Movement Disorders Unit, Barcelona, Spain
IIB St Pau, Biomed Res Inst St Pau, Barcelona, Spain
CIBERNED, Ctr Invest Biomed Red Enfermedades Neurodegenerat, Barcelona, Spain
Kulisevsky, J:
Hosp Santa Creu & Sant Pau, Dept Neurol, Movement Disorders Unit, Barcelona, Spain
IIB St Pau, Biomed Res Inst St Pau, Barcelona, Spain
CIBERNED, Ctr Invest Biomed Red Enfermedades Neurodegenerat, Barcelona, Spain
del Val, JL:
Hosp Clin Univ Lozano Blesa, Dept Neurol, San Juan Bosco 15, Zaragoza 50009, Spain
IIS Aragon, Res Grp Movement Disorders & Headache GIIS070, Zaragoza, Spain
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