Abstract
In normals, subcutaneous blood flow in the ankle region, measured by means of the 133Xe washout technique, decreases about 45% when the position of the ankle is changed from cardiac level to 50 cm below the heart. A sympathetic vascular axon reflex is responsible for this flow reduction. A normal response [mean blood-flow reduction, 49% (range, 40 to 64%)] was found in seven diabetics without neuropathy. In nine diabetics with autonomic neuropathy (beat-to-beat variation in heart rate less than or equal to 15 min-1 during hyperventilation), the reduction in blood flow on lowering of the ankle was also normal. A significant deterioration of the response was found in six diabetics with autonomic neuropathy, including orthostatic hypotension, in whom blood flow increased 23% (range, -35 to +77%). Autoregulation of blood flow, i.e., constancy of blood flow in the ankle region on lowering and elevating of the ankle 20 cm below and above cardiac level was intact in the patients with orthostatic hypotension, indicating a normal vascular smooth muscle function. In conclusion, in diabetic patients with orthostatic hypotension, the subcutaneous axon reflex is absent. This may be one of several factors responsible for their orthostatic hy...Continue Reading
Citations
Jan 1, 1993·Acta Diabetologica·M GfesserR Landgraf
Apr 16, 1984·Klinische Wochenschrift·V SchusdziarraE F Pfeiffer
Feb 23, 1999·Kidney International·M StumvollJ Gerich
Sep 30, 2000·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·M J HilzB Neundoerfer
Sep 1, 1991·Clinical Physiology·E B AndersonO Henriksen
Feb 1, 1982·Acta Physiologica Scandinavica·K SkagenV Dyrberg
May 9, 1987·British Medical Journal·N OlsenN Rossing
Nov 16, 2002·Heart·L BernardiG Merlini
Dec 1, 1981·The Journal of Clinical Investigation·J HilstedH Galbo
Sep 6, 2014·Current Diabetes Reports·Alin Stirban
Feb 1, 1997·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·E B Andersen, F Boesen
Dec 1, 1990·Kidney International·E HommelH H Parving
Mar 24, 2009·Neuroscience·H GuZ J Cheng
Aug 1, 1989·Diabetic Medicine : a Journal of the British Diabetic Association·A LocatelliG Pozza
Jun 1, 1988·Diabetes/metabolism Reviews·J R WilliamsonC Kilo
Feb 1, 1983·Clinical Physiology·K Bjerre-JepsenK H Tønnesen
Aug 1, 1982·Clinical Physiology·J HilstedL Sestoft
Feb 1, 1986·European Journal of Clinical Investigation·A BarnettE Espiner
Jun 1, 1984·Clinical Physiology·K JensenB Melgaard
Apr 1, 1983·Acta Neurologica Scandinavica·J Hilsted
Oct 2, 2020·Cardiovascular Diabetology·Martin H SørensenPeter Gæde
Oct 24, 2019·European Heart Journal Cardiovascular Imaging·Martin Heyn SørensenPeter Gæde
Mar 21, 2020·Diabetes Care·Martin H SørensenPeter Gæde
Oct 24, 2020·Cardiovascular Diabetology·Annemie Stege BojerPer Lav Madsen