Autonomic testing: which value for each cardiovascular test? An observational study

Acta Diabetologica
Federico BellavereGiuseppe Bax

Abstract

Cardiovascular autonomic testing is time consuming when adopting the entire Ewing battery of tests, hence, clinicians usually adopt an empirically reduced number of tests which may give controversial results. Our purpose was to examine the reliability of the cardiovascular tests most commonly used in autonomic diagnoses. We tested 334 subjects, from an original group of 3745, who had shown an altered deep breathing test to both Lying to standing and Valsalva manoeuvre, assuming a value of postural hypotension of more than 15 mmHg as a sign of almost true dysautonomia. VM showed the highest sensitivity (85%) and, when coupled to LS, highest specificity (83%). VM could be useful when screening for possible or early autonomic neuropathy, VM + LS is useful as a diagnostic tool for probable or advanced autonomic neuropathy, and VM + LS + PH is useful for certain diagnosis of definite or late stage autonomic neuropathy.

References

Mar 20, 1976·Lancet·D J EwingB F Clarke
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Apr 30, 2003·Diabetes Care·Aaron I VinikRoy Freeman
Jan 24, 2007·Circulation·Aaron I Vinik, Dan Ziegler
Apr 16, 2009·JAMA : the Journal of the American Medical Association·Lawrence H YoungUNKNOWN DIAD Investigators
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Jan 21, 2011·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·V SpalloneUNKNOWN Diabetic Neuropathy Study Group of the Italian Society of Diabetology

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Citations

Mar 17, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Kalliopi PafiliNikolaos Papanas
Mar 9, 2020·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Masashi SuzukiMasahisa Katsuno

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