Summary
Heart rate variation was measured at different rates of regular deep breathing (2.5 to 13 breaths/min) in 11 normal subjects and 13 diabetic patients with neuropathy, defined clinically by the absence of both ankle jerks or the presence of autonomic symptoms. Subjects were divided into those above and below 30 years old. Normal subjects showed twofold changes in heart rate variation with maximum variation at mean breathing rates of 6.3 and 5.5 breaths/min. Heart rate variation was significantly smaller than normal in the diabetic patients with neuropathy, at all of the frequencies tested in the younger group and 7 of the 13 test frequencies in the older group; the maximum variation occurred at slower mean breathing rates of 4.5 breaths/min (p < 0.005) and 4.1 breaths/ min (p < 0.01) respectively. Seven diabetic patients without neuropathy, with intact leg reflexes and < 30 years old, had normal heart rate variation but the maximum responses occurred at a mean breathing rate of 5.4 breaths/min, significantly slower than normal (p < 0.02). Measuring the breathing rate at which heart rate variation is maximal may be a sensitive way of detecting autonomic (vagal) neuropathy.
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References
Ewing DJ (1978) Cardiovascular reflexes and autonomic neuropathy. Clin Sci 55: 321–327
Sayers B McA (1973) Analysis of heart rate variability. Ergonomics 16: 17–32
Melcher A (1976) Respiratory sinus arrhythmia in man. A study in heart rate regulating mechanisms. Acta Physiol Scand [Suppl] 435: 1–31
Wheeler T, Watkins PJ (1973) Cardiac denervation in diabetes. Br Med J 4: 584–586
Mackay JD, Page M McB, Cambridge J, Watkins PJ (1980) Diabetic autonomic neuropathy. The diagnostic value of heart rate monitoring. Diabetologia 18: 471–478
Angelone A, Coulter NA (1964) Respiratory sinus arrhythmia: a frequency dependent phenomenon. J Appl Physiol 19: 479–482
Womack BF (1971) The analysis of respiratory sinus arrhythmia using spectral analysis of digital filtering. IEEE Trans Biomed Eng 18: 399–409
Kelman GR, Wann KT (1971) Studies in sinus arrhythmia. J Physiol (Lond) 213: 59–60P
Wines BJ (1971) Statistical principles in experimental design, 2nd edn, McGraw-Hill, New York, pp 518–539
Wines BJ (1971) Statistical principles in experimental design, 2nd edn, McGraw-Hill, New York, pp 185–196
Duchen LW, Anjorin A, Watkins PJ, Mackay JD (1980) Pathology of autonomic neuropathy in diabetes mellitus. Ann Intern Med 92: 301–302
Bennet T, Farquhar ID, Hosking DJ, Hampton JR (1978) Assessment of methods for estimating autonomic nervous control of the heart in patients with diabetes mellitus. Diabetes 27: 1167–1174
Gilliat RW, Willison RG (1962) Peripheral nerve conduction in diabetic neuropathy. J Neurol Neurosurg Psychiatry 25: 11–18
Sundkvist G, Aimer L-O, Lilja B (1979) Respiratory influence on heart rate in diabetes mellitus. Br Med J 1: 924–925
Ewing DJ, Borsey DQ, Bellavere F, Clarke BF (1981) Cardiac autonomic neuropathy in diabetes: comparison of measures of R-R interval variation. Diabetologia 21: 18–24
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Mackay, J.D. Respiratory sinus arrhythmia in diabetic neuropathy. Diabetologia 24, 253–256 (1983). https://doi.org/10.1007/BF00282709
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DOI: https://doi.org/10.1007/BF00282709