| Title | Combination of cardiorespiratory reflex parameters and heart rate variability power spectrum analysis for early diagnosis of diabetic cardiac autonomic neuropathy. | ||
| Author | Cabezas-Cerrato, J; Gonzalez-Quintela, A; Perez-Rodriguez, M; Calle, A; Faure-Noguera, E; Vazquez-Garcia, J A | ||
| Journal | Diabetes Metab | Publication Year/Month | 2009-Sep |
| PMID | 19570704 | PMCID | -N/A- |
| Affiliation | 1.University Department of Medicine and Service of Endocrinology and Nutrition, University Hospital of Santiago, USC, Santiago de Compostela, Spain. jose.cabezas@usc.es. | ||
AIM: The study objective was to compare cardiorespiratory reflex (CR-R) parameters and heart rate variability power spectrum (HRV-PS) analysis in the diagnosis of cardiac autonomic neuropathy (CAN) in diabetic patients. METHODS: Four CR-R tests (Valsalva manoeuvre, deep breathing, and two successive 5-minute periods with the subject supine and standing, respectively) were performed in 399 diabetic patients (58.6% male, median age: 51 years) and 105 healthy controls (40% male, median age: 34 years). Patients with two or more abnormal CR-R parameters were classified as CAN+, while those with only one abnormal CR-R parameter were considered CAN \'borderline\'. HRV-PS was performed in all study participants. RESULTS: The low-frequency (LF) area with the patient standing was reduced in CAN+ diabetics (median 35.6 normalized units [nu], n=31), in CAN \'borderline\' diabetics (median 64.3nu, n=70) and even in diabetics without CAN (median 89.4nu, n=298) versus control subjects (median 93.7nu; P<0.001, P<0.001 and P<0.05, respectively). Adding the abnormal (<2.5 nu) LF area to the diagnostic criteria in CAN \'borderline\' patients caused 11 (15.7%) patients to be considered CAN+. CONCLUSION: Combining abnormal CR-R parameters (I - E and I/E the most specific) with HRV-PS (particularly the LF area with the subject standing) allowed diagnosis of diabetic CAN at an earlier stage.