Spectral analysis of heart rate in diabetic autonomic neuropathy. A comparison with standard tests of autonomic function.
Power spectral analysis of the heart rate was compared with standard tests of autonomic function performed on 15 insulin-dependent diabetic patients with symptoms of autonomic dysfunction. The high-frequency power, low-frequency power, and total power of the heart rate power spectrum measured in the supine position--possible measures of parasympathetic nervous system function--were significant predictors of the expiratory-inspiratory ratio, the beat-to-beat heart rate difference on deep respiration, the standard deviation of the resting heart rate, the 30:15 ratio, and the Valsalva ratio. The change in low-frequency power on moving from the supine to upright position, a possible measure of sympathetic nervous system function, was a modest predictor of the systolic and diastolic blood pressure fall in response to postural change, but a poor predictor of the blood pressure response to isometric exercise and a cold stimulus. This study supports the role of heart rate power spectral analysis as a clinical test of autonomic function in patients with known or suspected autonomic failure.
Freeman
R
R
Division of Neurology, New England Deaconess Hospital, Boston, MA 02215.
Saul
J P
JP
Roberts
M S
MS
Berger
R D
RD
Broadbridge
C
C
Cohen
R J
RJ
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D013057:Spectrum Analysis