PETER J. WATKINS, M.D.; JONATHAN D. MACKAY, M.B., B.Chir.
Measurement of heart rate variation during deep breathing has been used as a diagnostic test of autonomic function. Normal subjects have considerable heart rate variation that is accentuated during deep breathing; this variation is diminished or sometimes absent in diabetics with autonomic neuropathy. Recording heart rate variation during deep breathing is a good method for establishing the presence of autonomic neuropathy: All normal subjects have a score greater than 9, and autonomic neuropathy is probably absent if the score is greater than 12. The optimal breathing rate for this test is six breaths per minute in nondiabetics but is usually less in diabetics with autonomic neuropathy. The use of six breaths per minute as a standard, however, enhances the ability of the test to discriminate normal from neuropathic patients. Impaired heart rate variation can be the earliest sign of diabetic neuropathy and may precede the appearance of autonomic symptoms by several years. Severe autonomic neuropathy may be responsible for spontaneous respiratory arrest and unexplained sudden deaths, which are not rare among these patients.
WATKINS PJ, MACKAY JD. Cardiac Denervation in Diabetic Neuropathy. Ann Intern Med. 1980;92:304–307. doi: 10.7326/0003-4819-92-2-304
Download citation file:
Published: Ann Intern Med. 1980;92(2_Part_2):304-307.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Neurology.
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use