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February 1991

Spectral Analysis of Heart Rate in Diabetic Autonomic Neuropathy: A Comparison With Standard Tests of Autonomic Function

Author Affiliations

From the Divisions of Neurology (Dr Freeman and Mr Broadbridge) and General Medicine (Dr Roberts), New England Deaconess Hospital; Department of Neurology, Beth Israel Hospital (Dr Freeman); Department of Cardiology, Children's Hospital Medical Center (Drs Saul and Cohen); Division of Health Science and Technology, Harvard-Massachusetts Institute of Technology (Drs Saul, Berger, and Cohen); Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital (Drs Berger and Cohen); and Harvard Medical School (Drs Freeman, Saul, Roberts, Berger, and Cohen), Boston, Mass.

Arch Neurol. 1991;48(2):185-190. doi:10.1001/archneur.1991.00530140079020

• Power spectral analysis of the heart rate was compared with standard tests of autonomic function performed on 15 insulin-dependent diabetic patients with symptoms of autonomic dysfunction. The high-frequency power, low-frequency power, and total power of the heart rate power spectrum measured in the supine position—possible measures of parasympathetic nervous system function—were significant predictors of the expiratory-inspiratory ratio, the beat-to-beat heart rate difference on deep respiration, the standard deviation of the resting heart rate, the 30:15 ratio, and the Valsalva ratio. The change in low-frequency power on moving from the supine to upright position, a possible measure of sympathetic nervous system function, was a modest predictor of the systolic and diastolic blood pressure fall in response to postural change, but a poor predictor of the blood pressure response to isometric exercise and a cold stimulus. This study supports the role of heart rate power spectral analysis as a clinical test of autonomic function in patients with known or suspected autonomic failure.