Clinics (Sao Paulo). 2020;75:e1299.

The mitochondrial calcium uniporter: a new therapeutic target for Parkinson’s disease-related cardiac dysfunctions?

Fúlvio Alexandre Scorza, Francisco Sandro Menezes-Rodrigues, Efraín Olszewer, Paolo Ruggero Errante, José Gustavo Patrão Tavares, Carla Alessandra Scorza, Henrique Ballalai Ferraz, Josef Finsterer , Afonso Caricati-Neto

DOI: 10.6061/clinics/2020/e1299

In 1817, the London surgeon and pharmacist James Parkinson published a 66-page-long booklet entitled “An Essay on the Shaking Palsy”, which contains the first detailed, clinical description of the shaking palsy, or “paralysis agitans”, which is currently known as Parkinson’s disease (PD) (). Two important facts James Parkinson probably did not consider at that time include the scientific progress of neuroscience over the past two centuries and the changes in the world’s population aging since then (). In fact, the world’s population is steadily becoming older. From 2015 to 2030, the number of individuals in the world aged ≥60 years is estimated to grow by 56%, from 901 million to 1.4 billion, and by 2050, it is estimated to be more than double the size of that of 2015, reaching approximately 2.1 billion (). Unfortunately, aging is the main risk factor for major human diseases, such as neurological and cardiovascular disorders (). Thus, the concluding remarks of the “Global Burden of Diseases, Injuries, and Risk Factors” (GBD) report are clear in stating that neurological disorders are a main cause of disability and death worldwide. Globally, the burden of neurological conditions has increased substantially over the past 25 years because populations are getting older ().

PD affects millions of people globally, but there is no cure, and its prevalence will double by 2030 (-). Although PD is not considered a “malignant“ or even a “fatal” disease, mortality is not a negligible matter among patients with PD. Recently, we analyzed mortality in PD. Of the approximately 97,000 scientific articles on PD analyzed in our study, 1650 articles related to mortality in PD were found (). Data from several well-designed studies suggest that mortality in PD patients is higher than that seen in the general population (-,). A large prospective cohort study clearly demonstrated that mortality in PD is not increased in the first 5 years after onset but increases thereafter, with a relative risk of 3.5 after 10 years (,). The leading causes of death in PD are pneumonia and cardiovascular diseases (,). Approximately 60% of PD patients have cardiovascular disorders (,). These disorders are present in almost all stages of PD, and heart rate variability seems to be a key feature, becoming less variable before any motor symptoms suggest PD (,).

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