Heartbeat and arrhythmia perception in diabetic autonomic neuropathy.
A comparative study of diabetics with autonomic neuropathy (N = 13) as against non-neuropathic diabetics (N = 16) and healthy control persons (N = 20) was carried out with respect to heart rate both at rest and under stress, frequency of cardiac arrhythmias in a 24-h ECG and accuracy of heartbeat and arrhythmia perception. In the subjects with diabetic autonomic neuropathy, the spontaneous variability and stress-induced reactivity of the heart rate as well as the number of tachycardic episodes were reduced, whereas the frequency of ventricular extrasystoles was somewhat increased. Impaired heartbeat perception and a complete loss of perception of arrhythmias as a consequence of neuropathic deafferentation could be demonstrated. Cardiac perception disorders also play a vital role in other clinical problems, e.g. silent myocardial infarction and lack of awareness of hypoglycaemia in diabetes mellitus.
Pauli
P
P
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany.
Hartl
L
L
Marquardt
C
C
Stalmann
H
H
Strian
F
F
D000328:Adult; D001143:Arousal / Q000502:physiology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D005117:Cardiac Complexes, Premature / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006321:Heart / Q000294:innervation; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D010465:Perception / Q000502:physiology; D011187:Posture / Q000502:physiology; D013610:Tachycardia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology