Influence of cardiovascular diseases upon the results of the cardiovascular reflex tests in diabetic and nondiabetic subjects |
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Authors: | Kornelia Krönert Katrin Holder Gudrun Kuschmierz Birgit Mayer Walter Renn Dieter Luft Manfred Eggstein |
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Institution: | 1. Abteilung Innere Medizin IV, Medizinische Universit?tsklinik, Otfried-Müller-Strasse 10, D-7400, Tübingen, FRG
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Abstract: | Summary Cardiovascular reflex tests are used to assess cardiac autonomic neuropathy in diabetes mellitus. Cardiovascular diseases
(CVD) are known to alter baroreflex mechanisms. Diabetic patients are at a high risk for cardiovascular complications. In
order to prove whether cardiovascular diseases reduce the diagnostic value of the cardiovascular reflex tests in diabetic
autonomic neuropathy unselected groups of 274 nondiabetic and 103 diabetic patients were studied: E/I, 30/15, and Valsalva
ratios, sustained handgrip test and blood pressure response to standing. Both groups were subdivided into young (≤45 years)
and older (>45 years) patients and into subjects with and without CVD. In young nondiabetic patients with CVD, E/I and Valsalva
ratios were significantly lower than in those without CVD. In young diabetic patients with CVD, only E/I ratios were significantly
reduced compared to those without CVD. The tests reflecting sympathetic nerve function did not differ between patients with
and without CVD, neither in the nondiabetic nor in the diabetic subjects. In the older nondiabetic and diabetic patients,
cardiovascular reflexes were generally impaired, but did not show any difference between subjects with and without CVD. In
young diabetic patients suffering from CVD, the diagnostic value of cardiovascular reflex tests is reduced as far as cardiac
autonomic neuropathy is concerned. In older patients, the tests are not suitable for the diagnosis of diabetic autonomic neuropathy.
More specific methods are required. |
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Keywords: | Cardiovascular diseases Cardiovascular reflex tests Diabetic autonomic neuropathy |
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