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Titolo:
Evidence of defective cardiovascular regulation in insulin-dependent diabetic patients without clinical autonomic dysfunction
Autore:
Weston, PJ; James, MA; Panerai, RB; McNally, PG; Potter, JF; Thurston, H;
Indirizzi:
Royaleyside,ool Univ Hosp, Dept Diabet & Endocrinol, Liverpool L7 8XP, Mers Royal Liverpool Univ Hosp Liverpool Merseyside England L7 8XP 7 8XP, Mers Glenfield Gen Hosp, Div Med Elderly, Leicester LE3 9QP, Leics, England Glenfield Gen Hosp Leicester Leics England LE3 9QP E3 9QP, Leics, England Univics,cester, Leicester Royal Infirm, Div Med Phys, Leicester LE1 5WW, Le Univ Leicester Leicester Leics England LE1 5WW hys, Leicester LE1 5WW, Le Univ Leicester, Dept Med & Therapeut, Leicester LE2 7LX, Leics, England Univ Leicester Leicester Leics England LE2 7LX er LE2 7LX, Leics, England
Titolo Testata:
DIABETES RESEARCH AND CLINICAL PRACTICE
fascicolo: 3, volume: 42, anno: 1998,
pagine: 141 - 148
SICI:
0168-8227(199812)42:3<141:EODCRI>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-RATE-VARIABILITY; BLOOD-PRESSURE VARIABILITY; CARDIAC REFLEX SENSITIVITY; POWER SPECTRAL-ANALYSIS; BAROREFLEX SENSITIVITY; MYOCARDIAL-INFARCTION; ARTERIAL-PRESSURE; BARORECEPTOR; NEUROPATHY; MELLITUS;
Keywords:
type I (insulin-dependent) diabetes mellitus; autonomic function; spectral analysis; baroreceptor-cardiac reflex sensitivity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Weston, PJ Royal Liverpool Univ Hosp, Dept Diabet & Endocrinol, Prescott St, Liverpool Royal Liverpool Univ Hosp Prescott St Liverpool Merseyside England L7 8XP
Citazione:
P.J. Weston et al., "Evidence of defective cardiovascular regulation in insulin-dependent diabetic patients without clinical autonomic dysfunction", DIABET RE C, 42(3), 1998, pp. 141-148

Abstract

(1) Autonomic dysfunction is a well recognised complication of diabetes mellitus and early detection may allow therapeutic manoeuvres to reduce the associated mortality and morbidity. We sought to identify early cardiovascular autonomic neuropathy using spectral analysis of heart rate and systolic blood pressure variability. (2) Thirty patients with Type 1 (insulin-dependent) diabetes mellitus (DM) and 30 matched control subjects were studied. In addition to standard tests of autonomic function, heart rate and systolicblood pressure variability were assessed using power spectral analysis. From the frequency domain analysis of systolic blood pressure and R-R interval, the overall gain of baroreflex mechanisms was assessed, (3) Standard tests of autonomic function were normal in both groups. Total spectral power of R-R interval was reduced in the Type 1 DM group for low-frequency (473 +/- 63 vs. 747 +/- 78 ms(2), mean +/- S.E.M., P = 0.002) and high-frequency bands (125 +/- 13 vs. 459 +/- 90 ms(2), P < 0.0001). Systolic blood pressurelow-frequency power was increased in the diabetic group (9.3 +/- 1.2 vs. 6.6 +/- 0.7 mmHg(2), P < 0.05). The low frequency/high frequency ratio for heart rate variability was significantly higher in the Type 1 DM patients (4.6 +/- 0.5 vs. 2.9 +/- 0.5, P = 0.002), implying a relative sympathetic predominance. When absolute powers were expressed in normalised units, these differences persisted. There were significant reductions in baroreceptor-cardiac reflex sensitivity in Type 1 DM patients compared to controls while supine (9.7 +/- 0.7 vs. 18.5 +/- 1.7 ms/mmHg, P < 0.0001) and standing (2.9 +/- 0.9 vs. 7.18 +/- 1.9 ms/mmHg, P < 0.001). (4) Spectral analysis of cardiovascular variability detects autonomic dysfunction more frequently in Type1 DM patients than conventional tests, and is suggestive of an abnormalityof parasympathetic function. The abnormality of baroreceptor-cardiac reflex sensitivity could be explained by this impairment of parasympathetic function and this may predispose to the development of hypertension and increase the risk of sudden cardiac death. Using spectral analysis methods may allow detection of early diabetic cardiac autonomic neuropathy and allow therapeutic intervention to slow the progression. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 02:21:53