Quantitative Evaluation of Cardiac Parasympathetic Activity in Normal and Diabetic Man
| Autor: | A Reenan, David Tice, Daniel Porte, Daniel L. Cook, Jeffrey B. Halter, Michael A. Pfeifer, Sally Swedine, Joel Brodsky |
|---|---|
| Rok vydání: | 1982 |
| Předmět: |
Adult
Atropine Male medicine.medical_specialty Supine position Respiratory rate Endocrinology Diabetes and Metabolism Propranolol Parasympathetic nervous system Diabetic Neuropathies Heart Rate Parasympathetic Nervous System Internal medicine Heart rate Diabetes Mellitus Internal Medicine medicine Humans business.industry Respiration Heart Middle Aged Cardiovascular physiology Endocrinology medicine.anatomical_structure Breathing business medicine.drug |
| Zdroj: | Diabetes. 31:339-345 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/diab.31.4.339 |
| Popis: | Heart rate and RR variation (the standard deviation of the mean RR interval for a 5-min period) were evaluated as measurements of cardiac parasympathetic nervous system activity in fasting supine diabetic (N = 22) and comparable age normal (N = 22) subjects. The rate of breathing did not effect heart rate, but was inversely related to the RR variation (r = 0.89, P less than 0.01). Heart rate was increased (P less than 0.0001) and RR variation decreased (P less than 0.05) during beta-adrenergic stimulation with isoproterenol and during parasympathetic blockade with atropine (both P less than 0.0001). Hence, the cardiac effects of beta-adrenergic stimulation may mimic the effects of diminished parasympathetic function. To evaluate parasympathetic control of RR variation, independently of possible effects of increased sympathetic activities, studies were performed during beta-adrenergic blockade with propranolol. RR variation during propranolol was less both in 14 diabetic subjects without clinical symptoms of autonomic neuropathy (P less than 0.005) and in 8 diabetics with clinical symptoms of autonomic neuropathy (P less than 0.001) when compared with 22 age-comparable normal subjects. The measurement of RR variation was very reproducible with a day-to-day coefficient of variation of 9.7 +/- 2.8% (x +/- SEM) in diabetic subjects with stable hyperglycemia. It is concluded that supine RR variation during a deep respiratory rate and during beta-adrenergic blockade is a sensitive, quantitative, and reproducible method to evaluate parasympathetic nervous activity in normal and diabetic subjects. Furthermore, cardiac parasympathetic activity may be diminished in diabetic subjects before clinical symptoms of autonomic neuropathy are evident. |
| Databáze: | OpenAIRE |
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