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Reduced intraindividual variability of repeated cardiovascular reflex tests: an additional marker of autonomic neuropathy in insulin-dependent (type I) diabetes mellitus?
Acta Diabetol Lat. 1986 Oct-Dec; 23(4):279-89.AD

Abstract

The particular questions asked in our study were: 1. does the individual reproducibility of the cardiovascular reflex tests differ between healthy controls and patients suffering from type I diabetes mellitus and 2. if there is a difference, do the different cardiovascular reflexes vary in this regard? Nine healthy controls (4 women, 5 men, age 31 +/- 2.1 years) and 11 type I diabetics (4 women, 7 men, age 30.9 +/- 5.6 years, duration of diabetes 3.23 years) underwent the following tests 6 times in a 12-h period (07:00 to 19:00): variation of heart rate during deep breathing (E/I ratio), variation of heart rate during lying and standing (tachycardia/bradycardia or 30/15 ratio), Valsalva maneuver (Valsalva ratio), response of diastolic blood pressure to sustained hand grip, and response of systolic blood pressure to posture. The test results did not indicate a diurnal fluctuation nor were they systematically influenced by antecedent insulin injections or meals, either in diabetic patients or in healthy controls. The 11 diabetics had significantly lower intraindividual variations of E/I and Valsalva ratios than the controls (p less than 0.05, p less than 0.001, respectively). In the diabetics with parasympathetic failure the intraindividual variabilities of all cardiovascular reflex responses were lower than those of the patients with an intact autonomic nervous system as well as those of the control subjects. On the contrary, in the diabetic patients without autonomic neuropathy, only the intraindividual variability of the Valsalva maneuver was significantly attenuated (p less than 0.025), compared with the healthy volunteers. To conclude, the more pathological the single test result, the greater is its reproducibility and its clinical significance.

Authors

Krönert K
No affiliation info available
Luft D
No affiliation info available
Baumann B
No affiliation info available
Müller PH
No affiliation info available
Eggstein M
No affiliation info available

MeSH

AdultAutonomic Nervous System DiseasesBlood PressureDiabetes Mellitus, Type 1Diabetic NeuropathiesFemaleHeart RateHumansMaleReflex, AbnormalValsalva Maneuver

Pub Type(s)

Journal Article

Language

eng

PubMed ID

3564830

Citation

Krönert, K, et al. "Reduced Intraindividual Variability of Repeated Cardiovascular Reflex Tests: an Additional Marker of Autonomic Neuropathy in Insulin-dependent (type I) Diabetes Mellitus?" Acta Diabetologica Latina, vol. 23, no. 4, 1986, pp. 279-89.
Krönert K, Luft D, Baumann B, et al. Reduced intraindividual variability of repeated cardiovascular reflex tests: an additional marker of autonomic neuropathy in insulin-dependent (type I) diabetes mellitus? Acta Diabetol Lat. 1986;23(4):279-89.
Krönert, K., Luft, D., Baumann, B., Müller, P. H., & Eggstein, M. (1986). Reduced intraindividual variability of repeated cardiovascular reflex tests: an additional marker of autonomic neuropathy in insulin-dependent (type I) diabetes mellitus? Acta Diabetologica Latina, 23(4), 279-89.
Krönert K, et al. Reduced Intraindividual Variability of Repeated Cardiovascular Reflex Tests: an Additional Marker of Autonomic Neuropathy in Insulin-dependent (type I) Diabetes Mellitus. Acta Diabetol Lat. 1986 Oct-Dec;23(4):279-89. PubMed PMID: 3564830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced intraindividual variability of repeated cardiovascular reflex tests: an additional marker of autonomic neuropathy in insulin-dependent (type I) diabetes mellitus? AU - Krönert,K, AU - Luft,D, AU - Baumann,B, AU - Müller,P H, AU - Eggstein,M, PY - 1986/10/1/pubmed PY - 1986/10/1/medline PY - 1986/10/1/entrez SP - 279 EP - 89 JF - Acta diabetologica latina JO - Acta Diabetol Lat VL - 23 IS - 4 N2 - The particular questions asked in our study were: 1. does the individual reproducibility of the cardiovascular reflex tests differ between healthy controls and patients suffering from type I diabetes mellitus and 2. if there is a difference, do the different cardiovascular reflexes vary in this regard? Nine healthy controls (4 women, 5 men, age 31 +/- 2.1 years) and 11 type I diabetics (4 women, 7 men, age 30.9 +/- 5.6 years, duration of diabetes 3.23 years) underwent the following tests 6 times in a 12-h period (07:00 to 19:00): variation of heart rate during deep breathing (E/I ratio), variation of heart rate during lying and standing (tachycardia/bradycardia or 30/15 ratio), Valsalva maneuver (Valsalva ratio), response of diastolic blood pressure to sustained hand grip, and response of systolic blood pressure to posture. The test results did not indicate a diurnal fluctuation nor were they systematically influenced by antecedent insulin injections or meals, either in diabetic patients or in healthy controls. The 11 diabetics had significantly lower intraindividual variations of E/I and Valsalva ratios than the controls (p less than 0.05, p less than 0.001, respectively). In the diabetics with parasympathetic failure the intraindividual variabilities of all cardiovascular reflex responses were lower than those of the patients with an intact autonomic nervous system as well as those of the control subjects. On the contrary, in the diabetic patients without autonomic neuropathy, only the intraindividual variability of the Valsalva maneuver was significantly attenuated (p less than 0.025), compared with the healthy volunteers. To conclude, the more pathological the single test result, the greater is its reproducibility and its clinical significance. SN - 0001-5563 UR - https://www.unboundmedicine.com/medline/citation/3564830/Reduced_intraindividual_variability_of_repeated_cardiovascular_reflex_tests:_an_additional_marker_of_autonomic_neuropathy_in_insulin_dependent__type_I__diabetes_mellitus DB - PRIME DP - Unbound Medicine ER -