Quantitative Evaluation of Diabetic Autonomic Neuropathy by Using Heart Rate Variations—Determination of the Normal Range for the Diagnosis of Autonomic Neuropathy

Abstract

Heart rate (HR) variations -in supine resting position, during deep breathing and on standing - were measured in 162 healthy subjects and 168 diabetics by use of an instantaneous-HR-change continuous recorder. As indices of HR variations, the standard deviation of the HR at rest (SD of HR), the mean difference between maximal and minimal HR during deep breathing (∆ I-E) and the HR increase on standing (∆HR) were determined. In healthy subjects, the values for each test declined with age and the log-transformed data fitted the linear regression. The 90% confidence limits were calculated for the normal range and the values below normal range were defined as abnormal. In diabetics, the incidence of abnormal response were 19% in the SD of HR, 38% in the ∆I-E and 22% in the AHR. The ∆HR was the most sensitive index for the autonomic neuropathy. The ∆HR was considered to be able to detect the different mechanisms of neural reflexes because of the poor correlation between the ∆HR and the respiratory HR variations. The present studies suggested that ∆I-E and ∆HR should be measured at the same time to evaluate the autonomic neuropathy. diabetic autonomic neuropathy; heart rate variation. © 1985, Tohoku University Medical Press. All rights reserved.