Quantitative evaluation of diabetic autonomic neuropathy by using heart rate variations: Relationship between cardiac parasympathetic or sympathetic damage and clinical conditions.

Oikawa, Noboru; Umetsu, Masanori; Toyota, Takayoshi; Goto, Yuusuke

doi:10.1620/tjem.148.125

Cited by 6 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The question of whether sympathetic or parasympathetic nerve damage occurs first is rather complex, with differing viewpoints in the literature (11,31,34). It is likely that the findings in this study are due primarily to the fact that our blood pressure measurements are able to assess more subtle change than those of investigators who have been unable to find such differences in asymptomatic diabetic patients.…”

Section: Beat-to Beat Blood Pressure Responsementioning

confidence: 80%

“…Loss of normal heart-rate variation is one of the most sensitive indicators of parasympathetic damage to autonomic pathways and is generally evident in autonomic function tests such as deep breathing, the Valsalva maneuver, and postural change (4,(6)(7)(8)(9). Other tests, such as the blood pressure response to standing and to isometric handgrip, are used to evaluate sympathetic pathways.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects

et al. 1988

View full text Add to dashboard Cite

Nine insulin-dependent diabetic (IDDM) patients (aged 25-37 yr) with no symptoms of autonomic neuropathy and 15 healthy control subjects (aged 26-39 yr) were studied at rest and during tests of Valsalva maneuver, deep breathing, cold pressor, and postural change from sitting to standing. Continuous (beat-to-beat) measures were taken of heart rate, systolic blood pressure, diastolic blood pressure, and skin conductance. The diabetic patients were differentiated from the control group by the following: less variability in diastolic blood pressure during deep breathing, failure to exhibit diastolic blood pressure decreases during recovery from a cold pressor stimulus, a flatter blood pressure response pattern when changing from sitting to standing, and a smaller standing ratio (maximum/minimum) for R-R interval. Among the patients, age was negatively correlated with systolic and diastolic standing ratios and diastolic blood pressure variability during deep breathing. By use of the tracking cuff, a method of continuously recording blood pressure noninvasively, we have been able to assess subtle blood pressure changes, thereby revealing signs of sympathetic dysfunction in a group of relatively young diabetic patients with no symptoms of neuropathy. The tracking-cuff method of recording blood pressure has potential in further research on autonomic functioning in diabetic patients.

show abstract

Section: Beat-to Beat Blood Pressure Responsementioning

confidence: 80%

mentioning

confidence: 99%

Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects

et al. 1988

View full text Add to dashboard Cite

show abstract

“…The data of the present study suggests that decrease in total power of HRV results from a decrease in both sympathetic and parasympathetic components. In the presence of diabetes, the decrease in the parasympathetic component is more [24]. Jakovljevic et al had reported higher values of LF : HF ratio though it had not been compared with any control group.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Kumar

Singh

Jaryal

et al. 2016

International Journal of Hepatology

View full text Add to dashboard Cite

Aim. The present study was designed to evaluate the heart rate variability (HRV) in nonalcoholic fatty liver disease (NAFLD) and to assess the effect of grade of NAFLD and diabetic status on HRV. Methods. This cross-sectional study included 75 subjects (25 NAFLD without diabetes, 25 NAFLD with diabetes, and 25 controls). Measurements included anthropometry, body composition analysis, estimation of plasma glucose, serum lipids, hsCRP, and serum insulin. HRV analysis was performed in both time and frequency domains. Results. The time and frequency domain indices of overall variability (SDNN, total power) were significantly lower in NAFLD with diabetes as compared to the controls. However, the LF : HF ratio did not differ among the three groups. The variables related to obesity, lipid profile, and glucose metabolism were also higher in NAFLD with diabetes and those with Grade II NAFLD without diabetes, as compared to controls. Multivariate stepwise regression analysis showed a negative correlation between HRV and total cholesterol and fat percentage. Conclusion. The grade of NAFLD as well as diabetic status contributes to the decrease in the cardiovascular autonomic function, with diabetic status rather than grade of NAFLD playing a critical role. Serum lipids and adiposity may also contribute to cardiac autonomic dysfunction.

show abstract

Time and frequency domain assessment of heart rate variability: A theoretical and clinical appreciation

Spiers

Silke

McDermott

et al. 1993

Clinical Autonomic Research

View full text Add to dashboard Cite

Non-invasive techniques for assessing heart rate variability can be used either diagnostically, as in identification of autonomic neuropathy associated with diabetes mellitus or tissue rejection following cardiac transplantation, or as a prognostic indicator in coronary artery disease. The methodology is based upon calculation of successive R-R intervals from an electrocardiogram, which can then be plotted as a frequency histogram (time domain analysis), undergo power spectral analysis to yield information in the frequency domain or be applied to chaos theory. In this review, several parameters are discussed which can be derived to quantify heart rate variability in the time and frequency domains; the latter providing information on autonomic balance. In the frequency domain up to three peaks may be observed, with the peak below 0.15 Hz being mediated by sympathetic and parasympathetic activity and peaks above 0.15 Hz being of vagal origin. The effects of different physiological and pathophysiological conditions on various indices of heart rate variability, and the use of heart rate variability analysis as a pharmacological method to assess the impact of drug therapy on sympathovagal balance are discussed.

show abstract

Quantitative evaluation of diabetic autonomic neuropathy by using heart rate variations: Relationship between cardiac parasympathetic or sympathetic damage and clinical conditions.

Cited by 6 publications

References 10 publications

Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects

Beat-to-Beat Blood Pressure Response in Asymptomatic IDDM Subjects

Cardiovascular Autonomic Dysfunction in Patients of Nonalcoholic Fatty Liver Disease

Time and frequency domain assessment of heart rate variability: A theoretical and clinical appreciation

Contact Info

Product

Resources

About