title: Baroreflex analysis in diabetes mellitus: linear and nonlinear approaches.
abstract: The aim of our study was to employ novel nonlinear synchronization approaches as a tool to detect baroreflex impairment in young patients with subclinical autonomic dysfunction in Type 1 diabetes mellitus (DM) and compare them to standard linear baroreflex sensitivity (BRS) methods. We recorded beat-to-beat pulse interval (PI) and systolic blood pressure (SBP) in 14 DM patients and 14 matched healthy controls. We computed the information domain synchronization index (IDSI), cross-multiscale entropy, joint symbolic dynamics, information-based similarity index (IBSI) in addition to time domain and spectral measures of BRS. This multi parametric analysis showed that baroreflex gain is well-preserved, but the time delay within the baroreflex loop is significantly increased in patients with DM. Further, the level of similarity between blood pressure and heart rate fluctuations was significantly reduced in DM. In conclusion, baroreflex function in young DM patients is changed. The quantification of nonlinear similarity and baroreflex delay in addition to baroreflex gain may provide an improved diagnostic tool for detection of subclinical autonomic dysfunction in DM.
authors.affiliation: Department of Physiology, Jessenius Faculty of Medicine, Comenius University, MalaHora4, 03754, Martin, Slovakia. mjavorka@jfmed.uniba.sk
authors.forename: Michal
authors.initials: M
authors.lastname: Javorka
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Lazarova
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tonhajzerova
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Turianikova
authors.forename: Natasa
authors.initials: N
authors.lastname: Honzikova
authors.forename: Bohumil
authors.initials: B
authors.lastname: Fiser
authors.forename: Kamil
authors.initials: K
authors.lastname: Javorka
authors.forename: Mathias
authors.initials: M
authors.lastname: Baumert
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D017704:Baroreflex / Q000502:physiology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000503:physiopathology; D019277:Entropy; D005260:Female; D006801:Humans; D008297:Male; D017156:Photoplethysmography / Q000379:methods; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult