Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy
Abstract
We studied heart rate variability in 49 uncomplicated diabetics (27 with insulin therapy; 22 with oral hypoglycemic agents) and in 40 age-matched controls. An automatic autoregressive algorithm was used to compute the power spectral density (PSD) of beat by beat RR variability derived from the surface ECG. The PSD contains two major components (a low frequency approximately 0.1 Hz (LF) and a high frequency, respiratory linked, approximately 0.25 Hz (HF] that provide, respectively, quantitative markers of sympathetic and vagal modulatory activities and of their balance. As compared to controls, in diabetics, besides a reduced RR variance at rest (2722 +/- 300 and 1436 +/- 241 ms2, respectively), we observed during passive tilt an altered response of spectral indices of sympathetic activation and vagal withdrawal, suggestive of a complex modification in the neural control activities. In addition, we compared this approach to the commonly used clinical tests score, and observed that the latter provides overall results similar to those obtained with spectral changes induced by tilt (r = 0.42; P less than 0.01). Of potential clinical importance is that the data obtained with spectral analysis appear more thoroughly quantifiable and do not require the active collaboration of the patients.
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HF power of R-R variability (HRVHF) is a measure of cardiac parasympathetic activity.
“HF power of R-R variability (HRVHF) is a measure of cardiac parasympathetic activity (34).”
From Effects of glucagon-like peptide-1, yohimbine, and nitrergic modulation on sympathetic and parasympathetic activity in humans (2008) · cites this paper as [34]
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- Authors
- Pagani, M., Malfatto, G., Pierini, S., Casati, R., Masu, A. M., Poli, M., Guzzetti, S., Lombardi, F., Cerutti, S., & Malliani, A.
- Affiliations
- University of Milan (IT)
- Ospedale San Paolo (IT)
- Politecnico di Milano (IT)
- Corresponding author
- Pagani, Massimo
- Venue
- Journal of the Autonomic Nervous System
- Publisher
- Elsevier BV
- Published
- 1988-08
- Volume
- 23
- Issue
- 2
- Pages
- 143-153
- ISSN
- 0165-1838 (ISSN-L)
- OpenAlex
- W2027865289
- Cited by
- 378
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 9 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 6 · 2014: 10 · 2013: 9 · 2012: 13
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Autonomic Nervous System (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- heart rate variability, diabetic autonomic neuropathy, power spectral density, RR interval variability, autonomic function testing, insulin therapy, oral antidiabetic drugs
- MeSH terms
- Adolescent, Adult, Autonomic Nervous System Diseases, Diabetic Neuropathies, Diagnosis, Computer-Assisted, Heart Rate, Humans, Middle Aged, Posture
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