Diabetic cardiac autonomic dysfunction: Parasympathetic versus sympathetic

Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae

doi:10.1007/bf03164884

Cited by 23 publications

(14 citation statements)

References 21 publications

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“…Compared with previous literature, we found that HRV can indicate the state of both parasympathetic and sympathetic functions in diagnosed patients whom had heart diseases, coronary disease, hypertension, diabetes or vegetative nerve functional disturbance [1][2][3][4][5]. We also found that pulse wave had similar function to estimate those diseases.…”

Section: Introductionsupporting

confidence: 53%

Research of HRV and PRV under Electronic Synchronous Acquisition System

Zhang

Sun

2012

Advances in Mechanical and Electronic Engineering

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Abstract. In order to discuss the unity of heart rate variability (HRV) and pulse rate variability (PRV) and explore the relationship between HRV/PRV and the autonomic nervous. R-R intervals and P-P intervals were obtained from ECG and pulse signals of 17 healthy volunteers by synchronous acquisition system. HRV and PRV were analyzed offline by spectral analysis. And PRV derived from pulse wave corresponds well to traditional HRV derived from ECG. The results indicate that PRV and HRV had the same features which synchronous acquisition ECG and pulse wave, and the PRV may replace HRV to estimate the excitement of autonomic nervous.

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Section: Introductionsupporting

confidence: 53%

Research of HRV and PRV under Electronic Synchronous Acquisition System

Zhang

Sun

2012

Advances in Mechanical and Electronic Engineering

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“…[12][13][14]36) Moreover, Uehara, et al demonstrated that defects in parasympathetic innervation were more frequent and occurred relatively earlier in DM than defects in sympathetic innervation. 36) In this study, the density of AChE-positive nerves decreased homogeneously in DM rats compared to controls. In addition, the heterogeneity of AERP by PNS did not appear in DM rats, and the rate of an increased incidence of AERP by PNS was lower in DM than in control rats.…”

Section: A B C Discussionmentioning

confidence: 99%

Influences of Autonomic Nervous System on Atrial Arrhythmogenic Substrates and the Incidence of Atrial Fibrillation in Diabetic Heart

et al. 2009

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SummaryDiabetes mellitus (DM) is clinically associated with an increased incidence of atrial fibrillation (AF), but the underlying mechanism remains unclear. We hypothesized that neural remodeling enhances AF vulnerability in diabetic hearts. Eight weeks after creating streptozotocin-induced diabetic rats (DM rats) or control rats, the hearts were perfused according to the Langendorff method. Inducibility of AF was evaluated by 5 times burst pacing from the right atrium and the atrial effective refractory period (AERP) was measured. The protocol was repeated during sympathetic nerve stimulation (SNS) or parasympathetic nerve stimulation (PNS). In tissue samples taken from the right atrium, the density of nerves positive for tyrosine hydroxylase (TH) and acetylcholinesterase (AChE) were determined. SNS significantly increased the incidence of AF in DM rats (14 ± 6 to 30 ± 8%, P < 0.01), but not in control rats (11 ± 4 to 14 ± 6%, NS). Although AERP was significantly decreased by SNS in both rats (each P < 0.01), increased heterogeneity of AERP by SNS was seen only in DM rats. PNS significantly decreased AERP and increased the incidence of AF (9 ± 5 to 30 ± 5% in control rats, 12 ± 6 to 27 ± 6% in DM rats, each P < 0.01) in both rats. The density of TH-positive nerves was heterogeneous in DM rats compared with control rats, whereas the heterogeneity of AChE-positive nerves was not different in the rats. The prevalence of AF was enhanced by adrenergic activation in diabetic hearts, in which heterogeneous sympathetic innervation was evident. These results suggest that neural remodeling may play a crucial role for increased AF vulnerability in DM. (Int Heart J 2009; 50: 627-641)

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“…The regional uptake score of MIBG was visually determined for each of the total nine myocardial regions (basal anterior, basal septal, basal inferior, basal lateral, apical anterior, apical septal, apical inferior, apical lateral regions, and apex; fig. 1) according to a four-point scoring system: 3 = normal, 2 = mildly reduced, 1 = moderately reduced, and 0 = markedly reduced [18]. Early and late total uptake scores were defined as the sum of uptake scores of the nine regions in the early and late images, respectively.…”

Section: Methodsmentioning

confidence: 99%

Cardiac Autonomic Neuropathy in Patients with Chronic Renal Failure on Hemodialysis

Kurata¹,

Uehara²,

Sugi³

et al. 2000

Nephron

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To characterize uremic cardiac autonomic neuropathy, we measured plasma catecholamines, analyzed the 24-hour heart rate variability (HRV), and acquired serial images with ¹²³I-metaiodobenzylguanidine (MIBG) in 44 patients with chronic renal failure on hemodialysis and in 14 controls. Time-domain measures were calculated using the Marquette HRV program. MIBG clearance rates from the heart and lung were evaluated on planar images, and the regional MIBG uptake in the left ventricular myocardium was evaluated with single-photon emission computed tomography. Compared with controls, plasma dopamine and norepinephrine levels were elevated (p < 0.001 and p = 0.03, respectively), and all the time-domain measures of HRV were reduced in the patients (p < 0.001). The MIBG clearance rate from the heart was higher (p < 0.001), that from the lung was lower (p < 0.001), and the myocardial MIBG distribution was more heterogeneous in patients than in controls (total uptake score p ≤ 0.03). These variables were similar between 26 patients without and 18 patients with hypertension. Uremic cardiac autonomic neuropathy may be characterized by high plasma levels of dopamine and norepinephrine, reduced HRV, and abnormal MIBG kinetics in the heart with heterogeneous myocardial MIBG distribution, suggesting cardiac sympathetic overactivity and parasympathetic deterioration. In addition, abnormal MIBG kinetics in the lung may imply pulmonary sympathetic nervous dysfunction and/or endothelial dysfunction in uremic patients.

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Diabetic cardiac autonomic dysfunction: Parasympathetic versus sympathetic

Abstract: The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one.

Cited by 23 publications

References 21 publications

Research of HRV and PRV under Electronic Synchronous Acquisition System

Research of HRV and PRV under Electronic Synchronous Acquisition System

Influences of Autonomic Nervous System on Atrial Arrhythmogenic Substrates and the Incidence of Atrial Fibrillation in Diabetic Heart

Cardiac Autonomic Neuropathy in Patients with Chronic Renal Failure on Hemodialysis

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