Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson’s disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson’s disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate.

CHARACTERSTICS OF HEALTHY MEN HEMODYNAMICS IN A HYPOMAGNETIC ENVIRONMENT

Hemodynamics was studied in essentially healthy resting 8 male subjects exposed to an experimental hypomagnetic environment (HME). The cardio-respiratory system functioning was evaluated by 8-hour continuous monitoring of heart rate (HR), blood pressure (BP) fluctuations during every cardiac cycle, Kerdo autonomic index (KAI) and blood oxygenation (SpO2) in the Earth's natural magnetic field and a field attenuated in approximately 1,000 times. Comparative analysis of the measurements made in the control and HME tests elicited different trends. Thus, the HR average reduction amounted to 4 bpm; BP dropped significantly, i.e. diastolic BP by 11 mmHg and systolic BP, 16 mmHg on average. In HME, KAI rose commonly 20 %. Hemoglobin saturation did not change. The paper contains graphic interpretations of the KAI dependence on duration of the HME exposure. Mathematical modeling suggests a physiological interpretation of these results. More often than not sitting at rest in HME reduced substantially the modulating effect of parasympathetic regulation on the cardiovascular system in comparison with the control test in the normal geomagnetic field.

Organoprotection in patients with COVID-19

Background. Treatment of chronic coronary syndrome (CCS) includes the elimination of acute ischemic pain, prevention of ischemic pain, symptomatic treatment, and influence on the prognosis. The health of patients with CCS during their lifetime is affected by the diet, climate, medication, exposure to toxic substances, and now the COVID-19 epidemic. Objective. To describe the available options of cardioprotection and metabolic therapy. Materials and methods. Analysis of literature data on this topic and own research “Smart ECG”. Results and discussion. A significant number of the foreign scientists’ papers have been devoted to the problems of the excessive release of free radicals, mitochondrial DNA damage, reduction of ATP content and cardiocytoprotection. Even the short-term ischemia depletes ATP depots and slows their recovery. Metabolic therapy is able to protect cardiomyocytes from the hypoxic death due to the mismatch of energy production by mitochondria to the energy needs of the cell. According to the results of the own study “Smart ECG”, L-arginine and L-carnitine (Tivorel, “Yuria-Pharm”) activates parasympathetic regulation in stable angina, reducing the risk of adverse events. Vascular, immunomodulatory, antioxidant and cytoprotective properties of L-carnitine and L-arginine make their use reasonable for COVID-19. Conclusions. 1. Metabolic therapy is an important component of the treatment of CCS. 2. L-carnitine and L-arginine have the pronounced vascular, immunomodulatory, antioxidant and cytoprotective properties. 3. It is reasonable to use these drugs during an epidemic of COVID-19.