Reference : Squatting, a posture test for studying cardiovascular autonomic neuropathy in diabetes.
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
Human health sciences : Endocrinology, metabolism & nutrition
http://hdl.handle.net/2268/107366
Squatting, a posture test for studying cardiovascular autonomic neuropathy in diabetes.
English
PHILIPS, Jean-Christophe mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques]
MARCHAND, Monique mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
SCHEEN, André mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques]
2011
Diabètes & Métabolism
Masson
37
6
489-496
Yes (verified by ORBi)
1262-3636
Moulineaux Cedex 9
France
[en] Cardiovascular autonomic neuropathy ; arterial blood pressure ; squat test ; postural stress ; diabetes
[en] Cardiovascular autonomic neuropathy (CAN) is a frequent complication of diabetes mellitus, which is associated with increased morbidity and mortality. It involves both the parasympathetic and sympathetic nervous systems, and may be diagnosed by classical dynamic tests with measurements of heart rate (HR) and/or arterial blood pressure (BP). An original squat test (1-min standing, 1-min squatting, 1-min standing) was used with continuous monitoring of HR and BP, using a Finapres((R)) device. This active test imposes greater postural stress than the passive head-up tilt test, and provokes large changes in BP and HR that can be analyzed to derive indices of CAN. In healthy subjects, squatting is associated with BP increases and HR decreases (abolished by atropine: SqTv index), whereas the squat-stand transition is accompanied by a deep but transient drop in BP associated with sympathetic-driven tachycardia (abolished by propranolol: SqTs index). In diabetic patients with CAN, BP increases are accentuated during squatting whereas reflex bradycardia is reduced. When standing from squatting position, the fall in BP tends to be more pronounced and orthostatic hypotension more prolonged, while reflex tachycardia is markedly dampened. The baroreflex gain, similar to that calculated during pharmacological testing with vasodilator/vasopressor agents, can be derived by plotting pulse intervals (R-R) against systolic BP levels during the biphasic response following the squat-stand transition. The slope, which represents baroreflex sensitivity, is significantly reduced in patients with CAN. This discriminatory index allows study of the natural history of CAN in a large cohort of diabetic patients.
Researchers ; Professionals
http://hdl.handle.net/2268/107366
10.1016/j.diabet.2011.09.004
Copyright (c) 2011. Published by Elsevier Masson SAS.

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