COMPARATIVE-ASSESSMENT OF CARDIAC AUTONOM IC NEUROPATHY IN DIABETES WITH POWER SPECTRAL-ANALYSIS AND AUTOMATIC TESTS

Methods: 62 diabetic patients of both sex (age: 46 +/- 16 yr, BMI: 26. 1 +/- 4 kg/M2, casual blood pressure: 134 +/- 17/81 +/- 11 mmHg, mean age of diabetes: 11 +/- 9 yr) without cardiovascular medications were recruited. Autonomic involvement was based on the results from a batte ry of five cardiovascular tests as suggested by Ewing. The result of e ach test and a scoring system was considered. All patients underwent p ower spectral analysis (PSA) of digital blood pressure (BP) and RR int ervals recorded in the recumbent position and after tilting with a Fin apres(TM) monitor. The percentage of total power (0.025-0.4 Hz) comput ed in the low-frequency band (0.070-0.139 Hz) was choosen as a sympath etic index (SIGMA Ind). Results of tests were correlated with SIGMA In d. Results: 24 patients (39 %) have an autonomic involvement. The most affected tests are: the Valsalva maneuver (VAL): 16 %, RR response fr om lying to standing (LS): 25 %, sustained handgrip (SHG): 30 %, postu ral hypotension (PH): 57 %, deep breathing (DB): 87 %. Correlations co efficients of cardiovascular tests and SIGMA Ind are: VAL/SIGMA Ind (S BP tilt): r = 0.277, p = 0.029; VAL/SIGMA Ind (DBP tilt): r = 0.318, p = 0.012; VAL/SIGMA Ind (RR tilt): ns. PH/IndSIGMA. (SBP tilt): r = 0. 391, p = 0.0017; PH/SIGMA Ind (DBP tilt): r = -0.296, p = 0.019; PH/SI GMA Ind (RR tilt): r = - 0.308, p = 0.015, DB/SIGMA Ind (SBP tilt): r = 0.417, p = 0.0007; DB/SIGMA Ind (DBP tilt): r = 0.36 1, p = 0.0039; DB/SIGMA Ind (RR tilt) : ns. Results of LS and SHG show no correlation with Ind SIGMA. Correlations between global autonomic score (GAS) and SIGMA Ind during tilting have the following values: GAS/SIGMA Ind (SB P tilt): r = - 0486, p = 0.0001; GAS/SIGMA Ind (DBP tilt): r = - 0.385 , p = 0.002; GAS/SIGMA Ind (RR tilt): r = - 0.41 1, p = 0.0009. Conclu sions: The so-called sympathetic index computed from PSA are well corr elated with autonomic tests. They allow an early detection of sympathe tic involvement in diabetics patients. These results are to consider w hile managing these subjects.