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Titolo:
TIME AND FREQUENCY-DOMAIN ESTIMATES OF SPONTANEOUS BAROREFLEX SENSITIVITY PROVIDE EARLY DETECTION OF AUTONOMIC DYSFUNCTION IN DIABETES-MELLITUS
Autore:
FRATTOLA A; PARATI G; GAMBA P; PALEARI F; MAURI G; DIRIENZO M; CASTIGLIONI P; MANCIA G;
Indirizzi:
OSPED SAN GERARDO,CATTEDRA MED INTERNA,VIA DONIZETTI I-20052 MONZA ITALY OSPED SAN GERARDO,CATTEDRA MED INTERNA I-20052 MONZA ITALY UNIV MILAN,CATTEDRA MED INTERNA I-20122 MILAN ITALY OSPED S LUCA,IST SCI,IST AUXOL ITALIANO MILAN ITALY OSPED MAGGIORE,IRCCS,CTR FISIOL CLIN & IPERTENS MILAN ITALY LARC,CTR BIOINGN,FONDAZ PRO JUVENTUTE MILAN ITALY
Titolo Testata:
Diabetologia
fascicolo: 12, volume: 40, anno: 1997,
pagine: 1470 - 1475
SICI:
0012-186X(1997)40:12<1470:TAFEOS>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERIAL BLOOD-PRESSURE; RESPIRATORY SINUS ARRHYTHMIA; SUDDEN CARDIAC DEATH; HEART-RATE; SPECTRAL-ANALYSIS; CARDIOVASCULAR CONTROL; BARORECEPTOR REFLEX; NEUROPATHY; MORTALITY; RESPONSES;
Keywords:
DIABETES MELLITUS; AUTONOMIC NERVOUS SYSTEM; ARTERIAL BAROREFLEX; BLOOD PRESSURE VARIABILITY; HEART RATE VARIABILITY; BLOOD PRESSURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
A. Frattola et al., "TIME AND FREQUENCY-DOMAIN ESTIMATES OF SPONTANEOUS BAROREFLEX SENSITIVITY PROVIDE EARLY DETECTION OF AUTONOMIC DYSFUNCTION IN DIABETES-MELLITUS", Diabetologia, 40(12), 1997, pp. 1470-1475

Abstract

Diabetic autonomic dysfunction is associated with a high risk of mortality which makes its early identification clinically important. The aim of our study was to compare the detection of autonomic dysfunction provided by classical laboratory autonomic function tests with that obtained through computer assessment of the spontaneous sensitivity of the baroreceptor-heart rate reflex (BRS) by lime domain and frequency domain techniques. In 20 normotensive diabetic patients (mean age +/-SD41.9 +/- 8.1 years) with no evidence of autonomic dysfunction on laboratory autonomic testing (DO) blood pressure (BP) and ECG were continuously monitored over 15 min in the supine position, SRS was assessed as the slope of the regression line between spontaneous increases or reductions in systolic BP and linearly related lengthening or shorteningin RR interval over sequences of al feast 4 consecutive beats (sequence method), or as the squared ratio between RR interval and systolic BP spectral powers around 0.1 Hz. We compared the results with those of32 age-matched normotensive diabetic patients with abnormal autonomicfunction tests (D1) and with those of 24 healthy age-matched control subjects with normal autonomic function tests (C). Compared to C, BRS was markedly less in D1 when assessed by both the slope of the two types of sequences (data pooled) and by the spectral method (-71.3 % and -60.2 % respectively, both p < 0.01). However, BRS was consistently although somewhat less markedly reduced in DO, the reduction being clearly evident for all the estimates (-57.0 % and -43.5 %, both p < 0.01). The effects were more evident than those obtained by the simple quantification of the RR interval variability. These dal-a suggest that time and frequency domain estimates of spontaneous BRS allow earlier detection of diabetic autonomic dysfunction than classical laboratory autonomic tests. The estimates can be obtained by short non-invasive recording of the BP and RR interval signals in the supine patient, i.e. under conditions suitable for routine outpatient evaluation.

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Documento generato il 29/11/20 alle ore 10:09:21