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. Author manuscript; available in PMC: 2014 May 2.
Published in final edited form as: Pharmacol Ther. 2008 Jun 13;120(1):1–34. doi: 10.1016/j.pharmthera.2008.05.005

Table 5.

Diagnostic Tests for Cardiovascular Autonomic Neuropathy

Diagnostic Tests of CV Autonomic Neuropathy
Test Diagnostic Value
Resting heart rate >100 bpm
Beat-to-beat HR variation (HRV)
 Abstain from coffee overnight
 Do not test after hypoglycemic episode
 Supine position, 6 breaths per minute Difference < 10 bpm or expiration:inspiration
R-R ratio > 1.17
Heart rate response to standing
 R-R interval measured at beats 15 and 30 after standing (normally tachycardia is followed by reflex bradycardia) 30:15 ratio > 1.03
Heart rate response to Valsalva maneuver
 Patient forcibly exhales into manometer mouthpiece, exerting 40 mmHg pressure for 15 seconds Ratio of longest to shortest R-R interval < 1.2
Systolic BP response to standing
 Measure in supine position and 2 minutes after standing Decrease > 30 mmHg (10 to 29 is borderline)
Diastolic BP response to isometric exercise
 Establish patient’s maximum handgrip pressure
 Exert 30% maximum for 5 minutes Increase < 16 mmHg in contralateral arm
Electrocardiography QTc > 440 ms