Diabetic autonomic neuropathy: a more precise classification according to abnormality of cardiovascular reflexes
Espí, F.; Canteras, M.; Benages, A.; Carmena, R.
Medicina Clinica 87(8): 313-318
1986
ISSN/ISBN: 0025-7753 PMID: 3773584 Document Number: 285738
Cardiovascular reflexes were studied in 121 diabetic patients aged 20-65 to define the status of sympathetic cardiac denervation. The results of the study suggested the following 4-group classification: 1) 42 diabetic patients without cardiovascular autonomic neuropathy (all reflexes normal); 2) 41 diabetic patients with moderate parasympathetic neuropathy (abnormal maximal R-R/minimal R-R and/or abnormal variability of heart rate); 3) 14 diabetic patients with severe parasympathetic neuropathy and more or less severe vascular sympathetic neuropathy, with postural hypotension; 4) 20 diabetic patients with parasympathetic, vascular sympathetic and cardiac sympathetic involvement (nearly all reflexes with abnormal responses, including maximal increment of heart rate with orthostatism). Cardiovascular reflexes allow a qualitative differentiation of autonomic denervation.