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Relationship between retinal ischemia and cardiovascular autonomic damage in diabetes

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Summary

In order to investigate the relationship between ischemic diabetic retinopathy and cardiac autonomic dysfunction we studied 40 diabetic patients (mean age ± SEM: 48 ± 2 years). Retinopathy was evaluated by fluorescein angiography and patients were divided into three groups: a) with ischemic retinopathy (15 patients), b) with edematous retinopathy (13 patients) and c) without retinopathy (12 patients). Cardiac autonomic function was assessed by 4 tests based on cardiovascular reflexes (heart rate response to Valsalva maneuver and to deep breathing; systolic blood pressure fall after standing and diastolic blood pressure rise during handgrip) and by the cross-correlation test, a computerized technique for the analysis of respiratory sinus arrhythmia based on spectral analysis of electrocardiographic and respiratory signals. Abnormalities of cardiac autonomic tests were present in 26/40 patients (65%); considering the retinal angiographic classification, autonomic test abnormalities were found in 13/15 (86.6%) patients with ischemic retinopathy, in 7/13 (53.9%) patients with edematous retinopathy and in 6/12 (50%) patients without retinopathy. The prevalence of cardiac autonomic dysfunction was significantly higher (p<0.005) in the ischemic retinopathy group compared to the other groups. These results results show a strong association between ischemic retinopathy and cardiac autonomic dysfunction.

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Authors and Affiliations

  1. Dipartimento di Medicina Interna, IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy

    Angela Giardullo, Luigi Ricordi, Marco Rossi, Giuliano Marti, Pietro Fratino & Luciano Bernardi

  2. Sezione di Clinica Medica 1 e Clinica Oculistica, IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy

    Giulio Vandelli

Authors
  1. Angela Giardullo
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  2. Luigi Ricordi
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  3. Marco Rossi
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  4. Giuliano Marti
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  5. Giulio Vandelli
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  6. Pietro Fratino
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  7. Luciano Bernardi
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Giardullo, A., Ricordi, L., Rossi, M. et al. Relationship between retinal ischemia and cardiovascular autonomic damage in diabetes. Acta diabet. lat 26, 245–255 (1989). https://doi.org/10.1007/BF02581391

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