title: Relationship between retinal ischemia and cardiovascular autonomic damage in diabetes.
abstract: In order to investigate the relationship between ischemic diabetic retinopathy and cardiac autonomic dysfunction we studied 40 diabetic patients (mean age +/- SEM: 48 +/- 2 years). Retinopathy was evaluated by fluorescein angiography and patients were divided into three groups: a) with ischemic retinopathy (15 patients), b) with edematous retinopathy (13 patients) and c) without retinopathy (12 patients). Cardiac autonomic function was assessed by 4 tests based on cardiovascular reflexes (heart rate response to Valsalva maneuver and to deep breathing; systolic blood pressure fall after standing and diastolic blood pressure rise during handgrip) and by the cross-correlation test, a computerized technique for the analysis of respiratory sinus arrhythmia based on spectral analysis of electrocardiographic and respiratory signals. Abnormalities of cardiac autonomic tests were present in 26/40 patients (65%); considering the retinal angiographic classification, autonomic test abnormalities were found in 13/15 (86.6%) patients with ischemic retinopathy, in 7/13 (53.9%) patients with edematous retinopathy and in 6/12 (50%) patients without retinopathy. The prevalence of cardiac autonomic dysfunction was significantly higher (p less than 0.005) in the ischemic retinopathy group compared to the other groups. These results show a strong association between ischemic retinopathy and cardiac autonomic dysfunction.
authors.affiliation: Dipartimento di Medicina Interna, Università degli Studi di Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giardullo
authors.forename: L
authors.initials: L
authors.lastname: Ricordi
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Marti
authors.forename: G
authors.initials: G
authors.lastname: Vandelli
authors.forename: P
authors.initials: P
authors.lastname: Fratino
authors.forename: L
authors.initials: L
authors.lastname: Bernardi
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005451:Fluorescein Angiography; D006339:Heart Rate; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011187:Posture; D012119:Respiration; D012171:Retinal Vessels / Q000503:physiopathology*; D014636:Valsalva Maneuver