Side-effects of L-dopa on venous tone in Parkinson's disease: a leg-weighing assessment.
In the present study, the effects of L-dopa treatment on cardiovascular variables and peripheral venous tone were assessed in 13 patients with Parkinson's disease (PD) with Hoehn and Yahr stages 1-4. Patients were investigated once with their regular treatment and once after 12 h of interruption of L-dopa treatment. L-Dopa intake significantly reduced systolic and diastolic blood pressure, heart rate and plasma noradrenaline and adrenaline in both the supine and upright (60 degrees ) positions. A significant reduction in stroke volume and cardiac output was also seen with L-dopa. The vascular status of the legs was assessed through thigh compression during leg weighing, a new technique developed in our laboratory. Healthy subjects were used to demonstrate that this technique provided reproducible results, consistent with those provided by strain gauge plethysmography of the calf. When using this technique in patients with PD, L-dopa caused a significant lowering of vascular tone in the lower limbs as shown, in particular, by an increase in venous distensibility. Combined with the results of the orthostatic tilting, these findings support that the treatment-linked lowering of plasma noradrenaline in patients with PD was concomitant with a significant reduction in blood pressure, heart rate and vascular tone in the lower limbs. These pharmacological side-effects contributed to reduce venous return and arterial blood pressure which, together with a lowered heart rate, worsened the haemodynamic status.
Wolf
Jean-Pierre
JP
Physiologie, Faculté de Médecine and UPRES EA 3920 - IFR 133, Université de Franche Comté, F-25030 Besançon, France.
Bouhaddi
Malika
M
Louisy
Francis
F
Mikehiev
Andrei
A
Mourot
Laurent
L
Cappelle
Sylvie
S
Vuillier
Fabrice
F
Andre
Pierre
P
Rumbach
Lucien
L
Regnard
Jacques
J
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D015259:Dopamine Agents; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000473:pathology; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D009929:Organ Size / Q000187:drug effects; D010300:Parkinson Disease / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D010991:Plethysmography; D011187:Posture; D015203:Reproducibility of Results; D018667:Tilt-Table Test
D000978:Antiparkinson Agents; D015259:Dopamine Agents; D007980:Levodopa; D009638:Norepinephrine; D004837:Epinephrine