The potential prognostic role of cardiovascular autonomic failure in α‐synucleinopathies
Abstract
Cardiovascular autonomic failure is the second most common dysautonomic feature of α-synucleinopathies and has significant impact on daily activities and quality of life. Here we provide a systematic review of cardiovascular autonomic failure in α-synucleinopathies, emphasizing its impact on cognitive functions and disease outcomes. Articles spanning the period between January 1985 and April 2012 were identified from the PubMed database using a keyword-based search. Epidemiological studies highlight the negative prognostic effect of cardiovascular autonomic failure on cardiovascular and cerebrovascular outcomes and overall mortality in all α-synucleinopathies. Altered cerebral perfusion, vascular pressure stress, and related disruption of the blood-brain barrier may also contribute to the white matter hyperintensities and cognitive dysfunction frequently found in patients affected by neurocardiovascular instability. These findings support the hypothesis that cardiovascular autonomic failure may play a negative prognostic role in α-synucleinopathies and suggest that precocious screening and therapeutic management of cardiovascular autonomic failure may positively impact disease course.
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OH is frequently associated with a nocturnal 'non-dipping' or even 'reverse-dipping' BP pattern in patients with autonomic failure, with relevant therapeutic and prognostic implications.
“There is strong evidence that OH is frequently associated with a nocturnal 'non-dipping' or even 'reverse-dipping' BP pattern in patients with autonomic failure, with relevant therapeutic and prognostic implications 140,148-151”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [151]
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- Authors
- Fanciulli, A., Strano, S., Colosimo, C., Caltagirone, C., Spalletta, G., & Pontieri, F. E.
- Affiliations
- Azienda Ospedaliera Sant'Andrea (IT)
- Sapienza University of Rome (IT)
- University of Rome Tor Vergata (IT)
- Fondazione Santa Lucia (IT)
- Corresponding author
- Pontieri, F. E.
- Venue
- European Journal of Neurology
- Publisher
- Wiley
- Published
- 2012-07-27
- Volume
- 20
- Issue
- 2
- Pages
- 231-235
- ISSN
- 1351-5101 (ISSN-L)
- 1468-1331
- OpenAlex
- W2172237510
- Cited by
- 77
- References
- 97
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 11 · 2016: 9 · 2015: 6 · 2014: 7 · 2013: 5
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- Pfizer
- University of Cambridge
- H. Lundbeck A/S
- Ipsen
- UCB Pharma
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- synucleinopathies, Parkinson's disease, multiple system atrophy, prognosis, mortality, cerebrovascular outcomes, cognitive impairment, cerebral perfusion, blood-brain barrier, white matter hyperintensities, autonomic dysfunction
- MeSH terms
- Brain, Cardiovascular System, Cognition Disorders, Fatigue, Humans, Hypotension, Orthostatic, Parkinson Disease, Prognosis, Disease Progression, Multiple System Atrophy, Neurodegenerative Diseases, Lewy Body Disease, alpha-Synuclein, Primary Dysautonomias, Pure Autonomic Failure
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