The DOI matches its Crossref record.
The Value of Cardiovascular Autonomic Function Tests: 10 Years Experience in Diabetes
Abstract
Five simple, noninvasive cardiovascular reflex tests have been used to assess autonomic function in one center over the past 10 yr. Seven hundred seventy-four diabetic subjects were tested for diagnostic and research purposes. In 543 subjects completing all five tests, abnormalities of heart rate tests occurred in 40%, while abnormal blood pressure tests occurred in < 20%. Their results were grouped as normal (39%), early (15%), definite (18%), and severe (22%) involvement. Six percent had an atypical pattern of results. Two hundred thirty-seven diabetic subjects had the tests repeated ≤3 mo apart: 26% worsened, 71% were unchanged, and only 3% improved. The worsening followed a sequential pattern with first heart rate and later additional blood pressure abnormalities. Comparison between a single test (heart rate response to deep breathing) and the full battery in 360 subjects showed that one test alone does not distinguish the degree or severity of autonomic damage. These tests provide a useful framework to assess autonomic neuropathy simply, quickly, and noninvasively.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cited by
Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. (1996) · Circulation · doi:10.1161/01.cir.93.5.1043 · Cited by 17,159
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289
Cardiovascular neural regulation explored in the frequency domain.
Malliani, A., Pagani, M., Lombardi, F., & Cerutti, S. (1991) · Circulation · doi:10.1161/01.cir.84.2.482 · Cited by 3,569
Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003) · Diabetes Care · doi:10.2337/diacare.26.5.1553 · Cited by 2,044
Heart rate variability: measurement and clinical utility.
Kleiger, R. E., Stein, P. K., & Bigger, J. T. (2005) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2005.10101.x · Cited by 1,290
Diabetic cardiovascular autonomic neuropathy
Vinik, A. I., & Ziegler, D. (2007) · Circulation · doi:10.1161/circulationaha.106.634949 · Cited by 1,255
A leptin missense mutation associated with hypogonadism and morbid obesity
Strobel, A., Issad, T., Camoin, L., Ozata, M., & Strosberg, A. D. (1998) · Nature Genetics · doi:10.1038/ng0398-213 · Cited by 1,158
Spallone, V., Ziegler, D., Freeman, R., Bernardi, L., Frontoni, S., Pop‐Busui, R., Stevens, M., Kempler, P., Hilsted, J., Tesfaye, S., et al. (2011) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1239 · Cited by 957
Heart Rate Variability ? A Historical Perspective
Billman, G. E. (2011) · Frontiers in Physiology · doi:10.3389/fphys.2011.00086 · Cited by 786
“R interval in response to simple autonomic challenges to detect autonomic neuropathy in diabetic patients (Murray et al., 1975; Ewing et al., 1985).”
BackgroundTesfaye, S., Stevens, L. K., Stephenson, J. M., Fuller, J. H., Plater, M., Ionescu-Tirgoviste, C., Nuber, A., Pozza, G., & Ward, J. D. (1996) · Diabetologia · doi:10.1007/s001250050586 · Cited by 695
Functional assessment of heart rate variability: physiological basis and practical applications
Pumprla, J., Howorka, K., Groves, D., Chester, M., & Nolan, J. (2002) · International Journal of Cardiology · doi:10.1016/s0167-5273(02)00057-8 · Cited by 629
Rijzewijk, L. J., van der Meer, R. W., Smit, J. W. A., Diamant, M., Bax, J. J., Hammer, S., Romijn, J. A., de Roos, A., & Lamb, H. J. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.07.062 · Cited by 559
“…abuse; known cardiovascular disease or diabetes-related complications, including proliferative retinopathy; autonomic neuropathy, as excluded by Ewing’s tests (15); microalbuminuria, as excluded by measurements of albumin/creatinine ratio in a urine sample; and all contraindications for MRI.”
BackgroundDonnelly, L. A., Morris, A. D., Frier, B. M., Ellis, J. D., Donnan, P. T., Durrant, R., Band, M. M., Reekie, G., & Leese, G. P. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01501.x · Cited by 511
Managing preexisting diabetes for pregnancy
Kitzmiller, J. L., Block, J. M., Brown, F. M., Catalano, P. M., Conway, D. L., Coustan, D. R., Gunderson, E. P., Herman, W. H., Hoffman, L. D., Inturrisi, M., et al. (2008) · Diabetes Care · doi:10.2337/dc08-9020 · Cited by 476
Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use
Bauer, A., Malik, M., Schmidt, G., Barthel, P., Bonnemeier, H., Cygankiewicz, I., Guzik, P., Lombardi, F., Müller, A., Oto, A., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.07.041 · Cited by 462
Gerritsen, J., Dekker, J. M., TenVoorde, B. J., Kostense, P. J., Heine, R. J., Bouter, L. M., Heethaar, R. M., & Stehouwer, C. D. A. (2001) · Diabetes Care · doi:10.2337/diacare.24.10.1793 · Cited by 456
Heart rate variability in type 2 diabetes mellitus: A systematic review and meta–analysis
Benichou, T., Pereira, B., Mermillod, M., Tauveron, I., Pfabigan, D., Maqdasy, S., & Dutheil, F. (2018) · PLOS ONE · doi:10.1371/journal.pone.0195166 · Cited by 419
Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy
Pagani, M., Malfatto, G., Pierini, S., Casati, R., Masu, A. M., Poli, M., Guzzetti, S., Lombardi, F., Cerutti, S., & Malliani, A. (1988) · Journal of the Autonomic Nervous System · doi:10.1016/0165-1838(88)90078-1 · Cited by 378
Diabetes, Glucose, Insulin, and Heart Rate Variability
Schroeder, E. B., Chambless, L. E., Liao, D., Prineas, R. J., Evans, G. W., Rosamond, W. D., & Heiss, G. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.668 · Cited by 302
Gogitidze Joy, N., Hedrington, M. S., Briscoe, V. J., Tate, D. B., Ertl, A. C., & Davis, S. N. (2010) · Diabetes Care · doi:10.2337/dc09-0354 · Cited by 239
Ceriello, A., Novials, A., Ortega, E., Canivell, S., La Sala, L., Pujadas, G., Esposito, K., Giugliano, D., & Genovese, S. (2013) · Diabetes Care · doi:10.2337/dc12-2469 · Cited by 204
Autonomic Neuropathy in Diabetes Mellitus
Verrotti, A., Prezioso, G., Scattoni, R., & Chiarelli, F. (2014) · Frontiers in Endocrinology · doi:10.3389/fendo.2014.00205 · Cited by 187
Wu, S.-D., & Lo, P.-C. (2008) · Biomedical Research · doi:10.2220/biomedres.29.245 · Cited by 153
Ceriello, A., Novials, A., Ortega, E., La Sala, L., Pujadas, G., Testa, R., Bonfigli, A. R., Esposito, K., & Giugliano, D. (2012) · Diabetes · doi:10.2337/db12-0224 · Cited by 155
Post-COVID-19 fatigue: a systematic review
Joli, J., Buck, P., Zipfel, S., & Stengel, A. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.947973 · Cited by 155
Howorka, K. (1997) · Cardiovascular Research · doi:10.1016/s0008-6363(97)00040-0 · Cited by 133
Picard, M., Tauveron, I., Magdasy, S., Benichou, T., Bagheri, R., Ugbolue, U. C., Navel, V., & Dutheil, F. (2021) · PLoS ONE · doi:10.1371/journal.pone.0251863 · Cited by 130
Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study
Gerritsen, J., Dekker, J. M., TenVoorde, B. J., Bertelsmann, F. W., Kostense, P. J., Stehouwer, C. D. A., Heine, R. J., Nijpels, G., Heethaar, R. M., & Bouter, L. M. (2000) · Diabetologia · doi:10.1007/s001250051344 · Cited by 121
Pagkalos, M., Koutlianos, N., Kouidi, E., Pagkalos, E., Mandroukas, K., & Deligiannis, A. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2007.035303 · Cited by 104
Ninkovic, V. M., Ninkovic, S. M., Miloradovic, V., Stanojevic, D., Babic, M., Giga, V., Dobric, M., Trenell, M. I., Lalic, N., Seferovic, P. M., et al. (2016) · Acta Diabetologica · doi:10.1007/s00592-016-0864-y · Cited by 100
Andersen, S. T., Witte, D. R., Fleischer, J., Andersen, H., Lauritzen, T., Jørgensen, M. E., Jensen, T. S., Pop-Busui, R., & Charles, M. (2018) · Diabetes Care · doi:10.2337/dc18-1411 · Cited by 99
Nocturnal hypertension and impaired sympathovagal tone in Turner syndrome
Gravholt, C. H., Hansen, K. W., Erlandsen, M., Ebbehøj, E., & Christiansen, J. S. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000200509.17947.0f · Cited by 90
Effects of controlled hypoglycaemia on cardiac repolarisation in patients with type 1 diabetes
Koivikko, M. L., Karsikas, M., Salmela, P. I., Tapanainen, J. S., Ruokonen, A., Seppänen, T., Huikuri, H. V., & Perkiömäki, J. S. (2008) · Diabetologia · doi:10.1007/s00125-007-0902-y · Cited by 89
Balcıoğlu, S., Arslan, U., Türkoğlu, S., Özdemir, M., & Çengel, A. (2007) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.03.106 · Cited by 83
Zoppini, G., Cacciatori, V., Raimondo, D., Gemma, M., Trombetta, M., Dauriz, M., Brangani, C., Pichiri, I., Negri, C., Stoico, V., et al. (2015) · Diabetes Care · doi:10.2337/dc15-0081 · Cited by 74
Meyer, C., Hering, B. J., Gromann, R., Brandhorst, H., Brandhorst, D., Gerich, J., Federlin, K., & Bretzel, R. G. (1998) · Transplantation · doi:10.1097/00007890-199807270-00017 · Cited by 66
Wiklund, U., Karlsson, M., Öström, M., & Messner, T. (2009) · Clinical Physiology and Functional Imaging · doi:10.1111/j.1475-097x.2008.00837.x · Cited by 58
Quan, C., Talley, N. J., Jones, M. P., Spies, J., & Horowitz, M. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.01943.x · Cited by 55
Rocchi, C., Pierantozzi, M., Galati, S., Chiaravalloti, A., Pisani, V., Prosperetti, C., Lauretti, B., Stampanoni Bassi, M., Olivola, E., Schillaci, O., et al. (2015) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.12437 · Cited by 31
Struhal, W., Javor, A., Brunner, C., Benesch, T., Schmidt, V., Vosko, M. R., & Ransmayr, G. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-140531 · Cited by 22
Nattero-Chávez, L., Redondo López, S., Alonso Díaz, S., Garnica Ureña, M., Fernández-Durán, E., Escobar-Morreale, H. F., & Luque-Ramírez, M. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02729 · Cited by 18
Heart rate turbulence in patients with poorly controlled diabetes mellitus type 2
Bissinger, A., Ruxer, J., Ahmed, R. B., & Lubinski, A. (2014) · Archives of Medical Science · doi:10.5114/aoms.2014.47819 · Cited by 16
Pavithran, P., Madanmohan, T., & Nandeesha, H. (2008) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2008.00052.x · Cited by 13
Brun, S., Berglund, A., Mortensen, K. H., Hjerrild, B. E., Hansen, K. W., Andersen, N. H., & Gravholt, C. H. (2019) · Clinical Endocrinology · doi:10.1111/cen.13983 · Cited by 13
(1989) · PubMed · Cited by 10
Metadata
- Authors
- Ewing, D. J., Martyn, C. N., Young, R. J., & Clarke, B. F.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1985-09-01
- Volume
- 8
- Issue
- 5
- Pages
- 491-498
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2021669309
- Cited by
- 1,434
- References
- 0
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.