Key result
Diabetics with autonomic neuropathy lacked the significant post-Valsalva overshoot in maximum amplitude of the praecordial accelerocardiogram seen in normal subjects and diabetics without neuropathy.
Why the study?
Does praecordial accelerocardiography during the Valsalva manoeuvre detect abnormal left ventricular contractility responses in diabetic patients with autonomic neuropathy?
Observational (n=16)
Does praecordial accelerocardiography during the Valsalva manoeuvre detect abnormal left ventricular contractility responses in diabetic patients with autonomic neuropathy?
Praecordial accelerocardiography can non-invasively detect the loss of cardiac adrenergic innervation in diabetic patients with autonomic neuropathy by identifying the absence of left ventricular contractility overshoot following the Valsalva manoeuvre.
May detect autonomic neuropathy via absent post-Valsalva DE overshoot in diabetes; leaves open validation as a diagnostic tool.
The left ventricular response to the Valsalva manoeuvre was studied in 5 normal subjects (group 1), 6 diabetics without autonomic neuropathy (group 2), and 5 diabetics with autonomic neuropathy (group 3), using the maximum amplitude of the praecordial accelerocardiogram (DE) as a noninvasive index of left ventricular performance. During the Valsalva manoeuvre DE decreased in all 3 groups. In groups 1 and 2, DE increased significantly above the control value after release of the manoveuvre (DE overshoot) but this did not occur in group 3. It is suggested that the overshoot of DE in groups 1 and 2 reflects an increase in left ventricular contractility after release of the Valsalva manoeuvre and the absence of an overshoot in DE in the patients with autonomic neuropathy is the result of loss of cardiac adrenergic innervation. The ability to detect an abnormal cardiovascular response to the Valsalva manoeuvre using the non-invasive technique of praecordial accelerocardiography may be of practical value in the assessment of left ventricular function.
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Hume et al. (1979) conducted an observational in Diabetes with and without autonomic neuropathy (n=16). Diabetic autonomic neuropathy vs. Normal subjects and diabetics without autonomic neuropathy was evaluated on Maximum amplitude of the praecordial accelerocardiogram (DE) overshoot after release of Valsalva manoeuvre. Diabetics with autonomic neuropathy lacked the significant post-Valsalva overshoot in maximum amplitude of the praecordial accelerocardiogram seen in normal subjects and diabetics without neuropathy.
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