Evidence for specific autoimmunity against sympathetic and parasympathetic nervous tissues in Type 1 diabetes mellitus and the relation to cardiac autonomic dysfunction

1998 ◽  
Vol 15 (6) ◽  
pp. 467-472 ◽  
Author(s):  
D. Muhr-Becker ◽  
A.G. Ziegler ◽  
A. Druschky ◽  
G. Wolfram ◽  
M. Haslbeck ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Cardiac Autonomic Dysfunction

scholarly journals Abnormal left ventricular torsion and cardiac autonomic dysfunction in subjects with type 1 diabetes mellitus

Metabolism ◽  
2011 ◽  
Vol 60 (8) ◽  
pp. 1115-1121 ◽  
Author(s):  
Milan K. Piya ◽  
Ganesh Nallur Shivu ◽  
Abd Tahrani ◽  
Kiran Dubb ◽  
Khalid Abozguia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Torsion ◽  
Cardiac Autonomic Dysfunction ◽  
Ventricular Torsion

scholarly journals Early Progression of the Autonomic Dysfunction Observed in Pediatric Type 1 Diabetes Mellitus

Hypertension ◽  
2009 ◽  
Vol 54 (5) ◽  
pp. 987-994 ◽  
Author(s):  
Daniela Lucini ◽  
Gianvincenzo Zuccotti ◽  
Mara Malacarne ◽  
Andrea Scaramuzza ◽  
Sara Riboni ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Early Progression ◽  
Pediatric Type 1 Diabetes

scholarly journals Daily blood pressure variations in patients with type 1 diabetes mellitus and nephropathy

2003 ◽  
Vol 49 (5) ◽  
pp. 5-10
Author(s):  
I. A. Bondar ◽  
V. V. Klimontov ◽  
Ye. A. Korolyova ◽  
L. I. Zheltova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Arterial Hypertension ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Blood Pressure Monitoring ◽  
Inpatient Setting ◽  
Systemic Hemodynamic

То study a relationship between systemic hemodynamic parameters, albuminuria, and autonomic dysfunction in patients with type 1 diabetes mellitus (DM-1) without obvious nephropathy, the authors examined 55 patients in the inpatient setting. Twenty-nine patients had a normal urinary albumin excretion (CAE), 26 patients had microalbuminuria. 24-hour blood pressure monitoring (24-h BPM) was occillometrically made. The average daily, average diurnal and nocturnal values of systolic and diastolic blood pressure (BP) were significantly higher in DM-1 patients with microalbuniuria than in those with normal UAE. Routine autonomic cardiovascular tests showed that the incidence and severity of autonomic neuropathy were also higher in patients with microalbuminuria. Arterial hypertension (AH) diagnosed in compliance with the 24-h BPM criteria was detected. in 17.2%) of the DM-1 patients with normal UAE and in 42.3%) of the patients with microalbuminuria. According to the data of 24-h BPM, the incidence of arterial hypertension was 1.7 times as high as that evidenced by single BP measurements. The specific feature of circadian hemodynamic variations in patients with DM-1 was a low nocturnal BP decrease. 37.9%) of the patients with normoalbuminuria and 61.5%) of the patients with microalbuminuria had no normal (>10%)) nocturnal BP lowering. Stepwise regression analysis has ascertained that in patients with DM-1 without obvious nephropathy, systemic hemodynamic disorders are associated with albuminuria, autonomic dysfunction, and glycemic monitoring quality.

scholarly journals Diagnostic Significance of a Mild Decrease of Baroreflex Sensitivity With Respect to Heart Rate in Type 1 Diabetes Mellitus

2013 ◽  
pp. 605-613
Author(s):  
J. SVAČINOVÁ ◽  
N. HONZÍKOVÁ ◽  
A. KRTIČKA ◽  
I. TONHAJZEROVÁ ◽  
K. JAVORKA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Heart Rate ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Baroreflex Sensitivity ◽  
Clinical Signs ◽  
Diagnostic Significance

Decreased baroreflex sensitivity is an early sign of autonomic dysfunction in patients with type-1 diabetes mellitus. We evaluated the repeatability of a mild baroreflex sensitivity decrease in diabetics with respect to their heart rate. Finger blood pressure was continuously recorded in 14 young diabetics without clinical signs of autonomic dysfunction and in 14 age-matched controls for 42 min. The recordings were divided into 3-min segments, and the mean inter-beat interval (IBI), baroreflex sensitivity in ms/mm Hg (BRS) and mHz/mm Hg (BRSf) were determined in each segment. These values fluctuated in each subject within 42 min and therefore coefficients of repeatability were calculated for all subjects. Diabetics compared with controls had a decreased mean BRS (p=0.05), a tendency to a shortened IBI (p=0.08), and a decreased BRSf (p=0.17). IBI correlated with BRS in diabetics (p=0.03); this correlation was at p=0.12 in the controls. BRSf was IBI independent (controls: p=0.81, diabetics: p=0.29). We conclude that BRS is partially dependent on mean IBI. Thus, BRS reflects not only an impairment of the quick baroreflex responses of IBI to blood pressure changes, but also a change of the tonic sympathetic and parasympathetic heart rate control. This is of significance during mild changes of BRS. Therefore, an examination of the BRSf index is highly recommended, because this examination improves the diagnostic value of the measurement, particularly in cases of early signs of autonomic dysfunction.

scholarly journals A Comparative Assessment of Cardiovascular Autonomic Reflex Testing and Cardiac 123I-Metaiodobenzylguanidine Imaging in Patients with Type 1 Diabetes Mellitus without Complications or Cardiovascular Risk Factors

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Triantafyllos Didangelos ◽  
Efstratios Moralidis ◽  
Eleni Karlafti ◽  
Konstantinos Tziomalos ◽  
Charalambos Margaritidis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Type 1 Diabetes Mellitus ◽  
Cardiovascular Risk Factors ◽  
Autonomic Dysfunction ◽  
Sympathetic Innervation ◽  
Autonomic Reflex

Aim. To compare the cardiovascular autonomic reflex tests (CARTs) with cardiac sympathetic innervation imaging with 123I-metaiodobenzylguanidine (MIBG) in patients with type 1 diabetes mellitus (T1DM). Patients and Methods. Forty-nine patients (29 males, mean age 36 ± 10 years, mean T1DM duration 19 ± 6 years) without cardiovascular risk factors were prospectively enrolled. Participants were evaluated for autonomic dysfunction by assessing the mean circular resultant (MCR), Valsalva maneuver (Vals), postural index (PI), and orthostatic hypotension (OH). Within one month from the performance of these tests, patients underwent cardiac MIBG imaging and the ratio of the heart to upper mediastinum count density (H/M) at 4 hours postinjection was calculated (abnormal values, H/M < 1.80). Results. Twenty-nine patients (59%) had abnormal CARTs, and 37 (76%) patients had an H/M_4 < 1.80 (p=0.456). MCR, PI, Vals, and OH were abnormal in 29 (59%), 8 (16%), 5 (10%), and 11 (22%) patients, respectively. When using H/M_4 < 1.80 as the reference standard, a cutoff point of ≥2 abnormal CARTs had a sensitivity of 100% but a specificity of only 33% for determining CAN. Conclusions. CARTs are not closely associated with 123I-MIBG measurements, which can detect autonomic dysfunction more efficiently than the former. In comparison to semiquantitative cardiac MIBG assessment, the recommended threshold of ≥2 abnormal CARTs to define cardiovascular autonomic dysfunction is highly sensitive but of limited specificity and is independently determined by the duration of T1DM.

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