Abstract
A study was carried out to establish a normal range for use in a deep breathing test of cardiac vagal integrity in diabetes mellitus. The change in heart rate resulting from taking a deep breath was recorded in 174 healthy subjects aged 16-89 years. Results were expressed as the ratio of the longest R-R interval during expiration to the shortest R-R interval during inspiration. This ratio declined appreciably with age (p less than 0.001) but was not significantly related to resting heart rate. An age-related normal range was constructed and its diagnostic value investigated in 134 diabetics (aged 15-70 years) with various degrees of neuropathy. The sensitivity for indicating autonomic dysfunction was high: six false-negative and one false-positive result were obtained. Measurement of this age-dependent ratio, which may be made with any electrocardiographic apparatus, provides a simple, accurate diagnostic screen for autonomic neuropathy in the clinic.
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Selected References
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- Bennett T., Farquhar I. K., Hosking D. J., Hampton J. R. Assessment of methods for estimating autonomic nervous control of the heart in patients with diabetes mellitus. Diabetes. 1978 Dec;27(12):1167–1174. doi: 10.2337/diab.27.12.1167. [DOI] [PubMed] [Google Scholar]
- Ewing D. J., Borsey D. Q., Bellavere F., Clarke B. F. Cardiac autonomic neuropathy in diabetes: comparison of measures of R-R interval variation. Diabetologia. 1981 Jul;21(1):18–24. doi: 10.1007/BF03216217. [DOI] [PubMed] [Google Scholar]
- Mackay J. D., Page M. M., Cambridge J., Watkins P. J. Diabetic autonomic neuropathy. The diagnostic value of heart rate monitoring. Diabetologia. 1980 Jun;18(6):471–478. doi: 10.1007/BF00261703. [DOI] [PubMed] [Google Scholar]
- Smith S. E., Smith S. A., Brown P. M., Fox C., Sönksen P. H. Pupillary signs in diabetic autonomic neuropathy. Br Med J. 1978 Sep 30;2(6142):924–927. doi: 10.1136/bmj.2.6142.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith S. E., Smith S. A. Heart rate variability in healthy subjects measured with a bedside computer-based technique. Clin Sci (Lond) 1981 Oct;61(4):379–383. doi: 10.1042/cs0610379. [DOI] [PubMed] [Google Scholar]
- Sundkvist G., Almér L. 0., Lilja B. Respiratory influence on heart rate in diabetes mellitus. Br Med J. 1979 Apr 7;1(6168):924–925. doi: 10.1136/bmj.1.6168.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wieling W., van Brederode J. F., de Rijk L. G., Borst C., Dunning A. J. Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia. 1982 Mar;22(3):163–166. doi: 10.1007/BF00283745. [DOI] [PubMed] [Google Scholar]