title: Methods of investigation for cardiac autonomic dysfunction in human research studies.
abstract: This consensus document provides evidence-based guidelines regarding the evaluation of diabetic cardiovascular autonomic neuropathy (CAN) for human research studies; the guidelines are the result of the work of the CAN Subcommittee of the Toronto Diabetic Neuropathy Expert Group. The subcommittee critically reviewed the limitations and strengths of the available diagnostic approaches for CAN and the need for developing new tests for autonomic function. It was concluded that the most sensitive and specific approaches currently available to evaluate CAN in clinical research are: (1) heart rate variability, (2) baroreflex sensitivity, (3) muscle sympathetic nerve activity, (4) plasma catecholamines, and (5) heart sympathetic imaging. It was also recommended that efforts should be undertaken to develop new non-invasive and safe CAN tests to be used in clinical research, with higher sensitivity and specificity, for studying the pathophysiology of CAN and evaluating new therapeutic approaches.
authors.affiliation: Department of Internal Medicine, IRCCS S.Matteo and University of Pavia, Pavia, Italy. lbern1ps@unipv.it.
authors.forename: Luciano
authors.initials: L
authors.lastname: Bernardi
authors.forename: Vincenza
authors.initials: V
authors.lastname: Spallone
authors.forename: Martin
authors.initials: M
authors.lastname: Stevens
authors.forename: Jannik
authors.initials: J
authors.lastname: Hilsted
authors.forename: Simona
authors.initials: S
authors.lastname: Frontoni
authors.forename: Rodica
authors.initials: R
authors.lastname: Pop-Busui
authors.forename: Dan
authors.initials: D
authors.lastname: Ziegler
authors.forename: Peter
authors.initials: P
authors.lastname: Kempler
authors.forename: Roy
authors.initials: R
authors.lastname: Freeman
authors.forename: Phillip
authors.initials: P
authors.lastname: Low
authors.forename: Solomon
authors.initials: S
authors.lastname: Tesfaye
authors.forename: Paul
authors.initials: P
authors.lastname: Valensi
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003955:Diagnostic Tests, Routine; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D012680:Sensitivity and Specificity