Impaired circadian modulation of sympathovagal activity in diabetes : a possible explanation for altered temporal onset of cardiovascular disease
Diabetic subjects have a high incidence of cardiovascular accidents, with an altered circadian distribution. Abnormalities in the circadian rhythm of autonomic tone may be responsible for this altered temporal onset of cardiovascular disease. To assess circadian changes of sympathovagal balance in d...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1992-11, Vol.86 (5), p.1443-1452 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | BERNARDI, L RICORDI, L LAZZARI, P SOLDA, P CALCIATI, A FERRARI, M. R VANDEA, I FINARDI, G FRATINO, P |
| description | Diabetic subjects have a high incidence of cardiovascular accidents, with an altered circadian distribution. Abnormalities in the circadian rhythm of autonomic tone may be responsible for this altered temporal onset of cardiovascular disease.
To assess circadian changes of sympathovagal balance in diabetes, we performed 24-hour power spectral analysis of RR interval fluctuations in 54 diabetic subjects (age, 44 +/- 2 years) with either normal autonomic function or mild to severe autonomic neuropathy and in 54 age-matched control subjects. The power in the low-frequency (LF, 0.03-0.15 Hz) and high-frequency (HF, 0.18-0.40 Hz) bands was considered an index of relative sympathetic and vagal activity, respectively. Diabetic subjects with autonomic abnormalities showed a reduction in LF compared with control subjects (5.95 +/- 0.12 In-msec2 versus 6.73 +/- 0.11, p < 0.001) and an even greater reduction in LF, particularly during the night and the first hours after awakening (5.11 +/- 0.18 In-msec2 versus 6.52 +/- 0.14, p < 0.001). Day-night rhythm in sympathovagal balance was reduced or absent in diabetic subjects compared with control subjects.
Diabetic subjects with or without signs of autonomic neuropathy have a decreased vagal activity (and hence a relatively higher sympathetic activity) during night hours and at the same time of the day, during which a higher frequency of cardiovascular accidents has been reported. These observations may provide insight into the increased cardiac risk of diabetic patients, particularly if autonomic neuropathy is present. |
| doi_str_mv | 10.1161/01.cir.86.5.1443 |
| format | Article |
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To assess circadian changes of sympathovagal balance in diabetes, we performed 24-hour power spectral analysis of RR interval fluctuations in 54 diabetic subjects (age, 44 +/- 2 years) with either normal autonomic function or mild to severe autonomic neuropathy and in 54 age-matched control subjects. The power in the low-frequency (LF, 0.03-0.15 Hz) and high-frequency (HF, 0.18-0.40 Hz) bands was considered an index of relative sympathetic and vagal activity, respectively. Diabetic subjects with autonomic abnormalities showed a reduction in LF compared with control subjects (5.95 +/- 0.12 In-msec2 versus 6.73 +/- 0.11, p < 0.001) and an even greater reduction in LF, particularly during the night and the first hours after awakening (5.11 +/- 0.18 In-msec2 versus 6.52 +/- 0.14, p < 0.001). Day-night rhythm in sympathovagal balance was reduced or absent in diabetic subjects compared with control subjects.
Diabetic subjects with or without signs of autonomic neuropathy have a decreased vagal activity (and hence a relatively higher sympathetic activity) during night hours and at the same time of the day, during which a higher frequency of cardiovascular accidents has been reported. These observations may provide insight into the increased cardiac risk of diabetic patients, particularly if autonomic neuropathy is present.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.86.5.1443</identifier><identifier>PMID: 1423958</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Autonomic Nervous System Diseases - physiopathology ; Biological and medical sciences ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Circadian Rhythm - physiology ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - physiopathology ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic Neuropathies - physiopathology ; Electrocardiography, Ambulatory - methods ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Humans ; Male ; Medical sciences ; Reproducibility of Results ; Risk Factors ; Signal Processing, Computer-Assisted ; Sympathetic Nervous System - physiopathology ; Vagus Nerve - physiopathology</subject><ispartof>Circulation (New York, N.Y.), 1992-11, Vol.86 (5), p.1443-1452</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c519t-6cae661859fc23c79a28a4dcbfffd729fdf36a1fa0ad6fc729272c3ce13c76063</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4422072$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1423958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BERNARDI, L</creatorcontrib><creatorcontrib>RICORDI, L</creatorcontrib><creatorcontrib>LAZZARI, P</creatorcontrib><creatorcontrib>SOLDA, P</creatorcontrib><creatorcontrib>CALCIATI, A</creatorcontrib><creatorcontrib>FERRARI, M. R</creatorcontrib><creatorcontrib>VANDEA, I</creatorcontrib><creatorcontrib>FINARDI, G</creatorcontrib><creatorcontrib>FRATINO, P</creatorcontrib><title>Impaired circadian modulation of sympathovagal activity in diabetes : a possible explanation for altered temporal onset of cardiovascular disease</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Diabetic subjects have a high incidence of cardiovascular accidents, with an altered circadian distribution. Abnormalities in the circadian rhythm of autonomic tone may be responsible for this altered temporal onset of cardiovascular disease.
To assess circadian changes of sympathovagal balance in diabetes, we performed 24-hour power spectral analysis of RR interval fluctuations in 54 diabetic subjects (age, 44 +/- 2 years) with either normal autonomic function or mild to severe autonomic neuropathy and in 54 age-matched control subjects. The power in the low-frequency (LF, 0.03-0.15 Hz) and high-frequency (HF, 0.18-0.40 Hz) bands was considered an index of relative sympathetic and vagal activity, respectively. Diabetic subjects with autonomic abnormalities showed a reduction in LF compared with control subjects (5.95 +/- 0.12 In-msec2 versus 6.73 +/- 0.11, p < 0.001) and an even greater reduction in LF, particularly during the night and the first hours after awakening (5.11 +/- 0.18 In-msec2 versus 6.52 +/- 0.14, p < 0.001). Day-night rhythm in sympathovagal balance was reduced or absent in diabetic subjects compared with control subjects.
Diabetic subjects with or without signs of autonomic neuropathy have a decreased vagal activity (and hence a relatively higher sympathetic activity) during night hours and at the same time of the day, during which a higher frequency of cardiovascular accidents has been reported. These observations may provide insight into the increased cardiac risk of diabetic patients, particularly if autonomic neuropathy is present.</description><subject>Adult</subject><subject>Autonomic Nervous System Diseases - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Circadian Rhythm - physiology</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>Electrocardiography, Ambulatory - methods</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Signal Processing, Computer-Assisted</subject><subject>Sympathetic Nervous System - physiopathology</subject><subject>Vagus Nerve - physiopathology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkUuLFDEUhcPgMLajezdCFuKuavKoSlXcSeOjYUAQXYfbeWikqlIm6WH6Z_iP5zbd6Cok95zv5p5LyGvOWs4Vv2O8tTG3o2r7lnedvCIb3ouu6Xqpn5ENY0w3gxTiOXlRym-8Kjn0N-SGd0LqftyQv7t5hZi9o8ix4CIsdE7uMEGNaaEp0HJERf2VHuAnTBRsjQ-xHmlcKIr3vvpC31Ogayol7idP_eM6wXK2h5QpTNWf-NXPa8qISEvx9US2kF1EbrHYLiOueCj-JbkOMBX_6nLekh-fPn7ffmnuv37ebT_cN7bnujbKgleKj70OVkg7aBAjdM7uQwhuEDq4IBXwAAycChZfxCCstJ6jWGEOt-Tdmbvm9OfgSzVzLNZP-HmfDsVgbFppzlHIzkKbccbsg1lznCEfDWfmtAXDuNnuvplRmd6ctoCWNxf2YT97999wjh3rby91HB6mkGGxsfyTdZ0QbBDyCdaKlEY</recordid><startdate>19921101</startdate><enddate>19921101</enddate><creator>BERNARDI, L</creator><creator>RICORDI, L</creator><creator>LAZZARI, P</creator><creator>SOLDA, P</creator><creator>CALCIATI, A</creator><creator>FERRARI, M. R</creator><creator>VANDEA, I</creator><creator>FINARDI, G</creator><creator>FRATINO, P</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19921101</creationdate><title>Impaired circadian modulation of sympathovagal activity in diabetes : a possible explanation for altered temporal onset of cardiovascular disease</title><author>BERNARDI, L ; RICORDI, L ; LAZZARI, P ; SOLDA, P ; CALCIATI, A ; FERRARI, M. R ; VANDEA, I ; FINARDI, G ; FRATINO, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c519t-6cae661859fc23c79a28a4dcbfffd729fdf36a1fa0ad6fc729272c3ce13c76063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Autonomic Nervous System Diseases - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Circadian Rhythm - physiology</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>Electrocardiography, Ambulatory - methods</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Signal Processing, Computer-Assisted</topic><topic>Sympathetic Nervous System - physiopathology</topic><topic>Vagus Nerve - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BERNARDI, L</creatorcontrib><creatorcontrib>RICORDI, L</creatorcontrib><creatorcontrib>LAZZARI, P</creatorcontrib><creatorcontrib>SOLDA, P</creatorcontrib><creatorcontrib>CALCIATI, A</creatorcontrib><creatorcontrib>FERRARI, M. R</creatorcontrib><creatorcontrib>VANDEA, I</creatorcontrib><creatorcontrib>FINARDI, G</creatorcontrib><creatorcontrib>FRATINO, P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BERNARDI, L</au><au>RICORDI, L</au><au>LAZZARI, P</au><au>SOLDA, P</au><au>CALCIATI, A</au><au>FERRARI, M. R</au><au>VANDEA, I</au><au>FINARDI, G</au><au>FRATINO, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impaired circadian modulation of sympathovagal activity in diabetes : a possible explanation for altered temporal onset of cardiovascular disease</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1992-11-01</date><risdate>1992</risdate><volume>86</volume><issue>5</issue><spage>1443</spage><epage>1452</epage><pages>1443-1452</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Diabetic subjects have a high incidence of cardiovascular accidents, with an altered circadian distribution. Abnormalities in the circadian rhythm of autonomic tone may be responsible for this altered temporal onset of cardiovascular disease.
To assess circadian changes of sympathovagal balance in diabetes, we performed 24-hour power spectral analysis of RR interval fluctuations in 54 diabetic subjects (age, 44 +/- 2 years) with either normal autonomic function or mild to severe autonomic neuropathy and in 54 age-matched control subjects. The power in the low-frequency (LF, 0.03-0.15 Hz) and high-frequency (HF, 0.18-0.40 Hz) bands was considered an index of relative sympathetic and vagal activity, respectively. Diabetic subjects with autonomic abnormalities showed a reduction in LF compared with control subjects (5.95 +/- 0.12 In-msec2 versus 6.73 +/- 0.11, p < 0.001) and an even greater reduction in LF, particularly during the night and the first hours after awakening (5.11 +/- 0.18 In-msec2 versus 6.52 +/- 0.14, p < 0.001). Day-night rhythm in sympathovagal balance was reduced or absent in diabetic subjects compared with control subjects.
Diabetic subjects with or without signs of autonomic neuropathy have a decreased vagal activity (and hence a relatively higher sympathetic activity) during night hours and at the same time of the day, during which a higher frequency of cardiovascular accidents has been reported. These observations may provide insight into the increased cardiac risk of diabetic patients, particularly if autonomic neuropathy is present.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>1423958</pmid><doi>10.1161/01.cir.86.5.1443</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 1992-11, Vol.86 (5), p.1443-1452 |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adult Autonomic Nervous System Diseases - physiopathology Biological and medical sciences Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Circadian Rhythm - physiology Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - physiopathology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - physiopathology Diabetes. Impaired glucose tolerance Diabetic Neuropathies - physiopathology Electrocardiography, Ambulatory - methods Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Male Medical sciences Reproducibility of Results Risk Factors Signal Processing, Computer-Assisted Sympathetic Nervous System - physiopathology Vagus Nerve - physiopathology |
| title | Impaired circadian modulation of sympathovagal activity in diabetes : a possible explanation for altered temporal onset of cardiovascular disease |
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