Cardiac autonomic neuropathy in fibromyalgia: Revisited

2021 ◽  
pp. 1-7
Author(s):  
Poorvi Kulshreshtha ◽  
Kishore Kumar Deepak ◽  
Raj Kumar Yadav ◽  
Didhiti Mukherjee
Keyword(s):  
Heart Rate ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Valsalva Maneuver ◽  
High Sensitivity ◽  
Cardiac Autonomic Neuropathy ◽  
Reactivity Test ◽  
Suitable Index ◽  
Deep Breathing Test ◽  
Very High

BACKGROUND: Fibromyalgia (FM) is associated with widespread autonomic dysfunction where sympathetic predominance explains associated complaints such as widespread pain, sleep disorders and anxiety. Recent studies indicate a possible neurovascular autonomic interaction in the pathogenesis of FM. OBJECTIVE: Our study paradigm included a modified Ewing’s battery of autonomic function tests to find the cardiac autonomic neuropathy (CAN) in FM patients. The battery comprises some tests such as the Valsalva maneuver, which are effort-dependent, so we also aimed to identify a potential simplified test out of the whole battery as an index marker of CAN in FM patients. METHODS: Forty-two female patients with FM were included in this study and were administered sympathetic and parasympathetic reactivity tests to explore the presence of CAN. We compared the results from each sympathetic and parasympathetic reactivity test against CAN. RESULTS: Delta heart rate in the deep breathing test was significantly different in patients with and without CAN. Delta heart rate also exhibited best diagnostic performance (AUC = 0.769, 95% CI: 0.619–0.920, p< 0.001), with 88% sensitivity, 64% specificity, and 89% negative predictive value (NPV). The 30: 15 ratio during the lying to standing test also emerged as a suitable index; however it did not show any difference between CAN and non-CAN patients. CONCLUSION: The delta heart rate has the best diagnostic accuracy, primarily in CAN’s exclusion by its very high sensitivity and NPV.

scholarly journals Cardiac Autonomic Neuropathy Measured by Heart Rate Variability and Markers of Subclinical Atherosclerosis in Early Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Hossein Fakhrzadeh ◽  
Ahmad Yamini-Sharif ◽  
Farshad Sharifi ◽  
Yaser Tajalizadekhoob ◽  
Mojde Mirarefin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Subclinical Atherosclerosis ◽  
Total Power ◽  
Cardiac Autonomic Neuropathy ◽  
Inverse Association

Cardiac autonomic neuropathy (CAN) is a critical complication of type 2 diabetes mellitus (T2DM). Heart rate variability (HRV) is a noninvasive tool to assess cardiac autonomic function. We aimed to evaluate whether CAN is associated with increased risk of atherosclerosis in T2DM. A total of 57 diabetic and 54 nondiabetic subjects, free of coronary heart disease, were recruited. Carotid intima media thickness (CIMT), coronary calcium score (CAC), and brachial Flow Mediated Dilation (FMD) were measured. Heart rate variability and vagal components of autonomic function were determined. Significant reduction of normalized HF power (P<0.05) and total power (P<0.01) was observed in T2DM. CIMT and CAC scores were significantly higher while FMD was significantly lower in diabetics (P<0.01 for all). Median HbA1c levels were significantly higher in diabetics. CIMT was inversely and independently associated with total power both in diabetics and controls (P<0.01 for both groups). There was also an inverse association between total power and median HbA1c. Autonomic dysfunction, especially parasympathetic neuropathy, was present since early-stage T2DM. This was related to subclinical atherosclerosis. Early detection of cardiac autonomic neuropathy can help us detect the development of atherosclerosis earlier in T2DM to prevent unfavorable outcomes.

scholarly journals Heart rate variability evaluation in the assessment of cardiac autonomic neuropathy in patients with type 2 diabetes

Cor et Vasa ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. e335-e344 ◽  
Author(s):  
Rudolf Metelka ◽  
Lubica Cibičková ◽  
Jaromíra Gajdová ◽  
Ondřej Krystyník
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy

Heart Rate/Stroke Volume Relationship During Upright Exercise in Long-Term Diabetics

1993 ◽  
Vol 18 (2) ◽  
pp. 148-162
Author(s):  
R. G. Haennel ◽  
K. K. Teo ◽  
A. Suthijumroon ◽  
M. P. J. Senaratne ◽  
M. Hetherington ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Autonomic Function ◽  
Valsalva Maneuver ◽  
Peak Exercise ◽  
Initial Increase ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Deep Breathing

The changes in stroke volume (SV) during upright exercise were studied in 20 insulin-dependent diabetics (IDDM) and 20 age- and sex-matched controls. None of the diabetics had any cardiovascular symptoms. In addition, tests of autonomic function were conducted in the diabetics, assessing changes in heart rate (HR) during deep breathing and the Valsalva maneuver. During exercise the SV in the controls gradually increased and then remained essentially unchanged until maximum HR was achieved. Seven of the diabetics failed to sustain an initial increase in SV (fall > 15%), eight showed a "delayed" increase in SV, and the remaining five demonstrated an increasing SV over the range from rest to peak exercise. Abnormal autonomic function results were found during deep breathing (four diabetics) and the Valsalva maneuver (four diabetics). Findings indicate that cardiac function could be abnormal in IDDM without evidence of autonomic dysfunction. This abnormality could be due to a specific cardiomyopathy. Key words: diabetes mellitus, cardiac function, upright exercise, autonomic neuropathy, cardiomyopathy

Cardiac autonomic activity and Type II diabetes mellitus

2005 ◽  
Vol 108 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Daniela MANZELLA ◽  
Giuseppe PAOLISSO
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Function ◽  
Single Photon ◽  
Low Cost ◽  
Photon Emission ◽  
Cardiac Autonomic Neuropathy ◽  
Emission Computed Tomography ◽  
Published Data ◽  
Increased Risk

CAN (cardiac autonomic neuropathy) is a common complication of diabetes. Meta-analyses of published data demonstrate that reduced cardiovascular autonomic function, as measured by heart rate variability, is strongly associated with an increased risk of silent myocardial ischaemia and mortality. A major problem in ischaemia-induced impairment of vascular performance in the diabetic heart is unrecognized cardiac sympathetic dysfunction. Determining the presence of CAN is based on a battery of autonomic function tests and techniques such as SPECT (single-photon emission computed tomography) and PET (positron emission tomography). Nevertheless, spectral analysis of heart rate variability seems to remain the primary technique in evaluating CAN, due to its low cost, easy use and good intra-individual reproducibility.

scholarly journals Systemic Amyloidosis and Cardiac Autonomic Neuropathy Associated with Waldenstrom’s Macroglobulinemia

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Aasems Jacob ◽  
Rishi Raj ◽  
Warren Walkow
Keyword(s):  
Heart Rate ◽  
Autonomic Neuropathy ◽  
Systemic Amyloidosis ◽  
Exercise Intolerance ◽  
Cardiac Autonomic Neuropathy ◽  
Waldenström’S Macroglobulinemia ◽  
Coronary Syndrome ◽  
Waldenstrom's Macroglobulinemia ◽  
Waldenstrom’S Macroglobulinemia ◽  
Waldenström's Macroglobulinemia

A 73-year-old male with long-standing Waldenstrom’s macroglobulinemia complicated with systemic amyloidosis presented with a witnessed syncopal episode. He had complaints of orthostatic dizziness and palpitations for few months. Orthostatic hypotension and peripheral neuropathy were demonstrated on physical examination. EKG, 24-hour Holter monitoring, and 2D echocardiogram were unremarkable. MRI of the brain ruled out stroke. Patients with amyloidosis can develop cardiovascular disease through amyloid cardiomyopathy, small vessel disease, conduction defects, pericardial effusion, or autonomic denervation. After ruling out other life-threatening causes, Ewing’s battery of tests was done to rule out cardiac autonomic neuropathy. Two heart rate tests and one blood pressure test were abnormal which indicated severe cardiac autonomic neuropathy. Cardiac autonomic neuropathy can mask symptoms of acute coronary syndrome and hence early diagnosis using the simple bedside maneuver is beneficial. The test is also important for prognostication. Absence of augmentation of cardiac output from inadequate autonomic stimulation will lead to postural hypotension, exercise intolerance, and tachycardia. There may be no change in heart rate with Valsalva or deep breathing both of which increase parasympathetic tone. As the condition progresses, it may result in cardiac denervation which can result in silent myocardial infarction, syncope, and sudden death.

scholarly journals Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators

2017 ◽  
Vol 1 (1) ◽  
pp. 6-9
Author(s):  
Roopam Bassi ◽  
Kiran   ◽  
Kawalinder Girgla
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Autonomic Function ◽  
Valsalva Maneuver ◽  
Well Being ◽  
Control Group ◽  
Relaxation Techniques ◽  
Mean Values ◽  
The Mean ◽  
The Difference

ABSTRACT Introduction In recent years, the various health benefits of meditation have been acknowledged by the scientific community as well as by the public. Apart from its physiological benefits, it can also improve the psychological and spiritual well-being. A case–control study was planned to investigate the effect of Rajyoga Meditation on cardiovascular autonomic activity in meditators and nonmeditators. Materials and methods The study was conducted on 100 subjects, randomized into two groups: meditators (n = 50; age 35.80 ± 7.69 years) and nonmeditators (n = 50; age 36.76 ± 6.38 years). The meditator group practiced meditation for 30 minutes in the morning as well as in the evening. The control group did not practice any type of meditation or relaxation techniques. The cardiovascular parameters – heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), and Valsalva maneuver tests – were performed in both the groups in the same environmental conditions. The data were compiled and analyzed using unpaired t test. Results The mean values of HR in meditators and the control group were 77.08 ± 5.39 and 80.68 ± 5.71 respectively, and the difference was statistically significant (p < 0.001). The mean values of SBP in meditators and nonmeditators were 124.60 ± 5.39 and 129.56 ± 4.30 mm Hg respectively, while those for DBP were 77.84 ± 4.65 and 80.80 ± 4.78 mm Hg respectively. The difference in both was statistically significant. In meditators, Valsalva ratio was 1.60 ± 0.20, while in nonmeditators, it was 1.33 ± 0.13, and the difference was highly significant. Conclusion Significant improvement is seen in physiological, cardiac, and parasympathetic parameters in Rajyoga meditators. A shift of the autonomic balance toward the parasympathetic side is seen. By purposefully energizing the parasympathetic system by meditation, we can combat the ill effects of stress and help heal many health conditions. How to cite this article Kiran, Thaman RG, Bassi R, Girgla K. Comparison of Autonomic Function using Valsalva Ratio, Heart Rate, and Blood Pressure in Meditators and Nonmeditators. Curr Trends Diagn Treat 2017;1(1):6-9.

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