title: Evaluation of cardiovascular risk in patients with Parkinson disease under levodopa treatment.
abstract: BACKGROUND
  Levodopa is the indispensable choice of medial therapy in patients with Parkinson disease (PD). Since L-dopa treatment was shown to increase serum homocysteine levels, a well-known risk factor for cardiovascular disorders, the patients with PD under L-dopa treatment will be at increased risk for future cardiovascular events. The objective of this study is to evaluate cardiovascular risk in patients with PD under levodopa treatment.
  
  
  METHODS
  The study population consisted of 65 patients with idiopathic PD under L-dopa treatment. The control group included 32 age and gender matched individuals who had no cognitive decline. Echocardiographic measurements, serum homocysteine levels and elastic parameters of the aorta were compared between the patients with PD and controls.
  
  
  RESULTS
  As an expected feature of L-dopa therapy, the Parkinson group had significantly higher homocystein levels (15.1 ± 3.9 µmol/L vs. 11.5 ± 3.2 µmol/L, P = 0.02). Aortic distensibility was significantly lower in the patients with PD when compared to controls (4.8 ± 1.5 dyn/cm(2) vs. 6.2 ± 1.9 dyn/cm(2), P = 0.016). Additionally, the patients with PD had higher aortic strain and aortic stiffness index (13.4% ± 6.4% vs. 7.4% ± 3.6%, P < 0.001 and 7.3 ± 1.5 vs. 4.9 ± 1.9, P < 0.001 respectively). Furthermore, serum homocysteine levels were found to be positively correlated with aortic stiffness index and there was a negative correlation between aortic distensibility and levels of serum homocysteine (r = 0.674, P < 0.001; r = -0.602, P < 0.001, respectively).
  
  
  CONCLUSIONS
  The patients with PD under L-dopa treatment have increased aortic stiffness and impaired diastolic function compared to healthy individuals. Elevated serum homocysteine levels may be a possible pathophysiological mechanism.
authors.affiliation: Department of Cardiology, Ordu University Medical School, Ordu, Turkey.
authors.forename: Zeki Yüksel
authors.initials: ZY
authors.lastname: Günaydın
authors.affiliation: Department of Neurology, Ordu University Medical School, Ordu, Turkey.
authors.forename: Fahriye Feriha
authors.initials: FF
authors.lastname: Özer
authors.affiliation: Department of Cardiology, Giresun University Medical School, Giresun, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karagöz
authors.affiliation: Department of Cardiology, Ordu University Medical School, Ordu, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bektaş
authors.affiliation: Department of Cardiology, Siyami Ersek Research and Training Hospital, İstanbul, Turkey.
authors.forename: Mehmet Baran
authors.initials: MB
authors.lastname: Karataş
authors.affiliation: Department of Cardiology, Giresun University Medical School, Giresun, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Vural
authors.affiliation: Department of Cardiology, Ordu University Medical School, Ordu, Turkey.
authors.forename: Adil
authors.initials: A
authors.lastname: Bayramoğlu
authors.affiliation: Department of Cardiology, Giresun University Medical School, Giresun, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Çelik
authors.affiliation: Department of Cardiology, Ordu University Medical School, Ordu, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yaman
keywords: Aortic distensibility; Aortic stiffness; Cardiovascular risk; Homocysteine; Parkinson disease