Key result
Thermal quantitative sensory testing predicts cardiac autonomic neuropathy with ~97% specificity.
Why the study?
Cardiovascular autonomic reflex tests for diagnosing cardiac autonomic neuropathy are relatively time consuming and require standardized conditions, prompting investigation of thermal quantitative sensory testing as a screening tool in diabetes.
Does thermal quantitative sensory testing accurately screen for cardiac autonomic neuropathy in patients with diabetes mellitus?
Observational (n=134)
Does thermal quantitative sensory testing accurately screen for cardiac autonomic neuropathy in patients with diabetes mellitus?
Effect estimate: 97.4% specificity, 60.9% sensitivity
Thermal quantitative sensory testing may serve as a highly specific screening tool for cardiac autonomic neuropathy in diabetic patients prior to more time-consuming reflex tests.
May aid specific CAN screening in diabetes; cross-sectional data leave open prospective validation against CARTs.
INTRODUCTION: Electrophysiological diagnosis of cardiac autonomic neuropathy (CAN) is based on the evaluation of cardiovascular autonomic reflex tests (CARTs). CARTs are relatively time consuming and must be performed under standardized conditions. This study aimed to determine whether thermal quantitative sensory testing (TQST) can be used as a screening tool to identify patients with diabetes at a higher risk of CAN. METHODS: Eighty-five patients with diabetes and 49 healthy controls were included in the study. Neurological examination, CARTs, TQST, biochemical analyses, and neuropathy symptom questionnaires were performed. RESULTS: CAN was diagnosed in 46 patients with diabetes (54%). CAN-positive patients with diabetes had significantly higher warm detection thresholds (WDT) and significantly lower cold detection thresholds (CDT) in all tested regions (thenar, tibia, and the dorsum of the foot). CDT on the dorsum < 21.8°C in combination with CDT on the tibia < 23.15°C showed the best diagnostic ability in CAN prediction, with 97.4 % specificity, 60.9% sensitivity, 96.6% positive predictive value, and 67.3% negative predictive value. CONCLUSION: TQST can be used as a screening tool for CAN before CART.
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Potočková et al. (2022) conducted an observational in Diabetes mellitus and cardiac autonomic neuropathy (n=134). Thermal quantitative sensory testing (TQST) vs. Cardiovascular autonomic reflex tests (CARTs) was evaluated on Diagnostic ability in CAN prediction (97.4% specificity, 60.9% sensitivity). Thermal quantitative sensory testing using cold detection thresholds on the dorsum and tibia predicted cardiac autonomic neuropathy with 97.4% specificity and 60.9% sensitivity.
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