Cardiovascular responses to tilting in healthy and diabetic subjects

Navarro, Xavier; Kennedy, William R.; Ferrer, María Teresa Martínez

doi:10.1016/0022-510x(91)90213-q

Cited by 13 publications

(13 citation statements)

References 31 publications

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“…In diabetic patients there is a well-documented attenuation of reflex bradycardia in response to increases in arterial pressure (5,6,17). Reflex tachycardia in response to decrease in arterial pressure is also impaired (5,38). In STZ-treated rats, baroreflex-mediated bradycardia has been reported to be reduced (12), normal (34,35), or even enhanced (26).…”

Section: Discussionmentioning

confidence: 99%

Effect of blockade of endogenous angiotensin II on baroreflex function in conscious diabetic rats

Maliszewska‐Scislo

Scislo

Rossi

2003

American Journal of Physiology-Heart and Circulatory Physiology

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Little is known about baroreflex control of renal nerve sympathetic activity (RSNA) or the effect of angiotensin II (ANG II) on the baroreflex in diabetes. We examined baroreflex control of RSNA and heart rate (HR) in conscious, chronically instrumented rats 2 wk after citrate vehicle (normal) or 55 mg/kg iv streptozotocin (diabetic) before and after losartan (5 mg/kg iv) or enalapril (2.5 mg/kg iv). Resting HR and RSNA were lower in diabetic versus normal rats. The range of baroreflex control of HR and the gain of baroreflex-mediated bradycardia were impaired in diabetic rats. Maximum gain was unchanged. The baroreflex control of RSNA was reset to lower pressures in the diabetic rats but remained otherwise unchanged. Losartan decreased mean arterial pressure (MAP) and increased HR and RSNA in both groups but had no influence on the baroreflex. Enalapril decreased MAP only in normal rats, yet the increase in HR and RSNA was similar in both groups. Thus in diabetic rats enalapril produced a pressure-independent increase in HR and RSNA. Enalapril exerted no effect on the baroreflex control of HR or RSNA in either group. These data indicate that in conscious rats resting RSNA is lower but baroreflex control of RSNA is preserved after 2 wk of diabetes. At this time, the baroreflex control of HR is already impaired and blockade of endogenous ANG II does not improve this dysfunction.

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Section: Discussionmentioning

confidence: 99%

Effect of blockade of endogenous angiotensin II on baroreflex function in conscious diabetic rats

Maliszewska‐Scislo

Scislo

Rossi

2003

American Journal of Physiology-Heart and Circulatory Physiology

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“…Similarly, Brake index represents the return of HR towards pre-tilt by calculating the percentage of change from the maximum response due to tilt. [9][10] SBP change after tilting was quantified by calculating SBP 30sec-0 , SBP 1 min-0 in one earlier study. 9 SBP 30sec-0 represents the difference between maximum fall of SBP in 30 seconds after tilt and the value of the pre-tilt SBP.…”

Section: Tilt Testmentioning

confidence: 99%

“…[6][7][8] Passive orthostatic test by a tilt table is a better choice to find the cardiovascular changes induced by upright postural change than active standing. 9 A passive tilt test is a simple test and it can measure changes in both heart rate and blood pressure due to orthostatic stress. 10 The effect of gravitational stress may cause shifting of central blood volume to dependent lower limb causing drop of BP.…”

mentioning

confidence: 99%

“…[11][12] HR increases immediately after tilting followed by mild bradycardia and then increase to steady values in healthy person. 9 This rate of initial increment of HR after tilting can be expressed in a mathematical deduction-Acceleration index. In addition, the mild decrement of HR after the phase of initial tachycardia in angulated tilt state can be expressed by Brake index.…”

mentioning

confidence: 99%

“…Whereas in case of brake index, it is much higher in healthy subjects than both group of diabetic patients with or without neuropathy. 9 The systolic BP (SBP) declined abruptly after tilting up then returned to baseline values by 20 seconds.Initial change of the Diastolic Blood Pressure(DBP) is similar to SBP. Just after tilting up it also drop from the resting supine value.Then it rises to maximum value within first 30 second after tilting.In previous studies they found no significant difference between values obtained at first minute and those at second and third minute of tilting in healthy subjects.In diabetic patients without neuropathy, the observed pattern of DBP change with time after tilting was almost similar to that of healthy subjects.…”

mentioning

confidence: 99%

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Cardiovascular responses to tilting in Type 2 Diabetic patients

Rejwana

Rimi²,

Sultana

et al. 2020

J Bangladesh Soc Physiol

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Background: Diabetes mellitus (DM) is a disorder with a debilitating effects on cardiac autonomic control. Multiple major cardiovascular risk factors associated with DM led diabetic patients at high risk of Cardiovascular Disease. Objective: To assess cardiovascular responses to tilting in Type 2 Diabetic patients (T2DM) with normal and abnormal autonomic function test. Methods: This experimental study was conducted on 60 patients of T2DM. Among them, 30 patients were with normal cardiovascular reflex test (group DN) and 30 patients were with abnormal test (group DA). Thirty(30) apparently healthy subjects with similar age and sex without any physical illness were enrolled as control. Tilt table test of all subjects was done by tilting at 60° for 10 min by using a motorized tilt table. Cardiovascular response to tilt test was assessed by calculating D Heart rate (Acceleration index and Brake index); DSBP (SBP 30s-0 and SBP1 min -0), DDBP (DBP 30s-0 and DBP1 min -0) after tilting. For statistical analysis, one-way ANOVA followed by Bonferroni post hoc was used. Results: In this study, the Acceleration index was significantly higher in patient group DN compared to control and DA(p<0.001). But the Brake index was significantly (p<0.01, p<0.05) lower in both group of patients compared to control. In addition, SBP 30sec-0 and SBP1 min-0 were significantly higher in DA than those of control and DN.DBP 30sec-0 and DBP1min-0 were significantly (p<0.001) lower in DA patients compared to DN and control. Conclusion: This study concluded that cardiovascular response to tilting was weak in T2DM patients and it was greatly affected in T2DM patients with abnormal autonomic function test. J Bangladesh Soc Physiol. 2020, December; 15(2): 78-84

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Neuropathy and mortality in diabetes: Influence of pancreas transplantation

et al. 1996

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We collected information on patient status and cause of death for 545 insulin‐dependent diabetic subjects who had cardiorespiratory reflex and nerve conduction tests performed to determine if presence and severity of autonomic and somatic neuropathy is associated with mortality and if a functioning pancreas transplantation (PTx) influences mortality. Follow‐up was 12–138 months. Abnormal cardiorespiratory reflexes were present in 417 patients and there was abnormal nerve conduction in 392 patients. Mortality rates for patients with abnormal tests were higher (P < 0.0001) than for patients with normal tests. A total neuropathy score that included cardiorespiratory and nerve conduction test scores predicted survival better than separate scores. Patients with moderate neuropathy, but not those with severe neuropathy, who retained a functioning PTx, had longer survival times than patients whose PTx failed in the first 3 months. Considering only patients transplanted after 1985, those with moderate neuropathy who retained a functioning PTx had even longer survival times than nontransplanted patients. © 1996 John Wiley & Sons, Inc.

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Cardiovascular responses to tilting in healthy and diabetic subjects

Cited by 13 publications

References 31 publications

Effect of blockade of endogenous angiotensin II on baroreflex function in conscious diabetic rats

Effect of blockade of endogenous angiotensin II on baroreflex function in conscious diabetic rats

Cardiovascular responses to tilting in Type 2 Diabetic patients

Neuropathy and mortality in diabetes: Influence of pancreas transplantation

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