Squatting, a posture test for studying cardiovascular autonomic neuropathy in diabetes

Philips, Jean-Christophe; Marchand, Monique; Scheen, André

doi:10.1016/j.diabet.2011.09.004

Cited by 17 publications

(15 citation statements)

References 40 publications

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“…This may be reasonable for a well-control protocol in laboratory settings which requires the subject to keep still during the whole procedure. However, for the ambulatory 24-h study, BP may change transiently within a few seconds during daily activities such as walking, eating or drinking, deep breathing, and posture change [18]- [20], as shown in Fig. 2.…”

Section: Measurement Of the Reference Bpmentioning

confidence: 99%

An Armband Wearable Device for Overnight and Cuff-Less Blood Pressure Measurement

Zheng

Yan

Zhang

et al. 2014

IEEE Trans. Biomed. Eng.

155

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24-h blood pressure (BP) has significant prognostic value for cardiovascular risk screening, but the present BP devices are mainly cuff-based, which are unsuitable for long-term BP measurement, especially during nighttime. In this paper, we developed an armband wearable pulse transit time (PTT) system for 24-h cuff-less BP measurement and evaluated it in an unattended out-of-laboratory setting. Ten healthy young subjects participated in this ambulatory study, where PTT was measured at 30-min interval by this wearable system and the reference BP was measured by a standard oscillometric ambulatory BP monitor. Due to the misalignment of BP and PTT on their recording time caused by the different measurement principles of the two BP devices, a new estimation method has been proposed: transients in PTT were removed from the raw data by defined criteria, and then evenly interpolated, low-pass filtered, and resampled to synchronize at the time when BP was recorded. The results show that with the proposed method, the correlation between PTT and systolic BP (SBP) during nighttime with dynamic range of 21.8 ± 14.2 mmHg has improved from -0.50 ± 0.24 to -0.62 ± 0.20 , and the difference between the estimated and reference SBP has improved from 0.7 ± 10.7 to 2.8 ± 8.2 mmHg with root mean square error reduced from 10.7 to 8.7 mmHg. In addition, the correlation between a very low frequency component of SBP and PTT obtained from the proposed method during nighttime is -0.80 ± 0.10 and the difference is 2.4 ± 5.7 mmHg for a dynamic BP range of 13.5 ± 8.0 mmHg. It is therefore concluded from this study that the proposed wearable system has great potential to be used for overnight SBP monitoring, especially to measure the averaged SBP over a long period.

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Section: Measurement Of the Reference Bpmentioning

confidence: 99%

An Armband Wearable Device for Overnight and Cuff-Less Blood Pressure Measurement

Zheng

Yan

Zhang

et al. 2014

IEEE Trans. Biomed. Eng.

155

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“…Dysautonomia is observed in different diseases in which small fiber are involved. Diabetes mellitus is the most common 6,11 . Despite of our little sample, we conclude that HCV-infected-patients with a sensory polyneuropathy can develop autonomic cardiovascular dysfunctions.…”

Section: Resultsmentioning

confidence: 99%

Autonomic evaluation of hepatitis C virus infected patients

Coutinho¹,

Bordalo²,

Nascimento³

2013

Arq. Neuro-Psiquiatr.

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Hepatitis C virus (HCV) affects 170 million people all over the world. In Brazil, the incidence of HCV-infected individuals is 5.1/100,000 habitants. The highest prevalence is seen in Acre State, in the Brazilian Amazon (22.7/100,000 habitants) 1 . HCVinfection has been associated with neurological manifestations, including peripheral neuropathy. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and distal sensory polyneuropathy have been reported. HCV-infection associated with central nervous system vasculitis was also referred. About 65% of infected patients are around 30 to 49 years old of age, and 30% will develop hepatocellular carcinoma. The physiopathology basis is still unknown 2 . It seems that there is no direct tissues lesion by the virus, but probably an immune response against the virus could develop the disease. There are few reports focusing the relation between the HCV and dysautonomia [3][4][5][6][7] . Our objective was to report the autonomic cardiovascular function in HCVinfected Brazilian patients with sensory small-fiber neuropathy. METHODSWe have included 12 consecutive HCV-infected patients with sensory small-fiber polyneuropathy. Patients were randomly selected from a cohort of more than 60 HCV patients followed in the Hepatitis Reference Center (Dr. Bordalo) of Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, Brazil. Patients with diabetes, arterial hypertension, severe liver dysfunction, other infections, including HIV and HTLV, use of ABSTRACTThere are few studies reporting the association between hepatitis C virus (HCV) infection and disautonomia. We have evaluated the autonomic cardiovascular function in 12 patients with sensory small-fiber polyneuropathy infected by HCV. The mean age was 49±13 years old. The mean infection time was 9.6 years in six (50%) patients. Thermal and pinprick hypoesthesia was observed in distal legs in all patients. Autonomic symptoms were referred by eight (66.7%) patients. Among patients with abnormal autonomic cardiovascular test, five (41.7%) showed abnormal results in two or more tests. Valsalva maneuver was abnormal in seven (58.3%) patients. We can consider that there is an association of both parasympathetic and sympathetic efferent cardiovascular dysfunction in this group of patients.Key words: hepatitis C, dysautonomia, small-fiber polyneuropathy. RESUMOExistem poucos estudos que relatam a associação entre infecção pelo vírus da hepatite C (HCV) e disautonomia. Avaliamos a função autonômica cardiovascular em 12 pacientes com polineuropatia de fibras finas e infectados pelo HCV. A idade média foi de 49±13 anos. O tempo de infecção média foi de 9,6 anos em seis (50%) pacientes. Hipoestesia termoalgésica foi observada nos segmentos distais das pernas em todos os pacientes. Sintomas autonômicos foram relatados por oito (66,7%) pacientes. No teste autonômico cardiovascular, cinco (41,7%) apresentaram resultados anormais em dois ou mais testes. Manobra de Valsalva foi anormal em sete (58,3%) pacientes. Podemos considerar qu...

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“…Les tests « au lit du malade » peuvent être complétés par l'analyse de la variabilité cyclique de la fréquence cardiaque par analyse spectrale des intervalles RR successifs, qui reste néan-moins un test de recherche clinique [48]. Un test original d'accroupissement (1-min debout, 1-min accroupi, 1-min debout couplé à un monitoring continu de la fréquence cardiaque et de la pression artérielle a également été proposé plus récemment [49].…”

Section: Dysautonomieunclassified