Prevalence of Cardiovascular Autonomic Dysfunction Assessed by Spectral Analysis, Vector Analysis, and Standard Tests of Heart Rate Variation and Blood Pressure Responses at Various Stages of Diabetic Neuropathy

Publisher Website
Google Scholar
Abstract
To establish a test battery for the detection and characterization of cardiovascular autonomic neuropathy (CADN) and to evaluate its prevalence, a number of autonomic function tests based on spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses were performed in 261 diabetic patients aged 11–76 years with various stages of peripheral neuropathy. The percentages of abnormal results in the individual tests based on heart rate variation were 6–31% in 115 patients without peripheral neuropathy, 16–45% in 61 patients with subclinical neuropathy, 22–59% in 73 patients with symptomatic peripheral neuropathy, and 67–100% in 12 patients with the latter in conjunction with autonomic symptoms (p 1 was 38.8%. We conclude that: (1) the stage of peripheral neuropathy is a strong determinant of the prevalence of CADN, but the latter may also be detected selectively; (2) the max/min 30:15 and Valsalva ratios represent the most frequently abnormal standard tests; and (3) the combination of indices based on spectral, vector and conventional analysis of heart rate variation tends to be relatively more sensitive in detecting CADN when compared with a modified version of the most commonly used test battery.