Reduction of 0.1 Hz microcirculatory fluctuations as evidence of sympathetic dysfunction in insulin-dependent diabetes

Luciano Bernardi, Marco Rossi, Stefano Leuzzi, Emilio Mevio, Gabriele Fornasari, Alessandro Calciati, Cesare Orlandi, Pietro Fratino

Research output: Contribution to journalArticle

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Abstract

Objective: Loss of spontaneous fluctuations in resting microcirculatory flow has been described in diabetes mellitus, but its mechanism remains unexplained. Methods: The autonomic control of forearm skin microcirculation was investigated in 23 insulin-dependent diabetic human subjects (median age 39 years, range 27-50) and in 23 age matched controls (median age 38 years, range 20-57), by laser-Doppler flowmetry. Using spectral analysis of spontaneous microvascular fluctuations, we measured the power of 0.1 Hz ('10- second rhythm') fluctuations, dependent on sympathetic control and of respiration-related, high-Frequency fluctuations, due to the transmission of mechanical chest activity. Autonomic function abnormalities were assessed by 5 tests of cardiovascular reflexes. Results: Abnormalities in cardiovascular autonomic tests were present in 7/23 patients: deep breathing was abnormal 4 in patients standing in 2, handgrip in 3, cross-correlation in 4 and Valsalva ratio in 0. The power of 0.1 Hz micro, circulatory fluctuations was significantly lower in diabetic than in control subjects (2.57 ± 0.16 vs 3.48 ± 0.09 In-mV2, mean ± s.e.m., P <0.001), whereas that of respiratory fluctuations was similar (2.60 ± 0.24 vs 2.56 ± 0.19 In-mV2. P=n.s.). The 0.1 Hz power was 2 standard deviations below the mean of controls (P <0.05) in 13/23 diabetic patients; this abnormality was significantly more frequent than abnormalities in any other autonomic test (P <0.001). Conclusions: Since the observed reduction was confined to those microvascular fluctuations trader autonomic control, but not to those dependent on passive mechanical transmission, the reduction in spontaneous microcirculatory vasomotion appears to he determined mainly by sympathetic dysfunction. Sympathetic impairment of skin microvascular control seems to be a common finding, and is probably an early index of autonomic dysfunction in insulin-dependent diabetes.

Original languageEnglish
Pages (from-to)185-191
Number of pages7
JournalCardiovascular Research
Volume34
Issue number1
DOIs
Publication statusPublished - Apr 1997

Fingerprint

Insulin
Respiration
Cardiovascular Abnormalities
Skin
Laser-Doppler Flowmetry
Microcirculation
Forearm
Reflex
Diabetes Mellitus
Thorax
Power (Psychology)

Keywords

  • Autonomic nervous system
  • Diabetes
  • Heart rate variability
  • Human
  • Laser-Doppler flowmetry
  • Microcirculation
  • Neuropathy
  • Spectral analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Reduction of 0.1 Hz microcirculatory fluctuations as evidence of sympathetic dysfunction in insulin-dependent diabetes. / Bernardi, Luciano; Rossi, Marco; Leuzzi, Stefano; Mevio, Emilio; Fornasari, Gabriele; Calciati, Alessandro; Orlandi, Cesare; Fratino, Pietro.

In: Cardiovascular Research, Vol. 34, No. 1, 04.1997, p. 185-191.

Research output: Contribution to journalArticle

Bernardi, L, Rossi, M, Leuzzi, S, Mevio, E, Fornasari, G, Calciati, A, Orlandi, C & Fratino, P 1997, 'Reduction of 0.1 Hz microcirculatory fluctuations as evidence of sympathetic dysfunction in insulin-dependent diabetes', Cardiovascular Research, vol. 34, no. 1, pp. 185-191. https://doi.org/10.1016/S0008-6363(97)00017-5
Bernardi, Luciano ; Rossi, Marco ; Leuzzi, Stefano ; Mevio, Emilio ; Fornasari, Gabriele ; Calciati, Alessandro ; Orlandi, Cesare ; Fratino, Pietro. / Reduction of 0.1 Hz microcirculatory fluctuations as evidence of sympathetic dysfunction in insulin-dependent diabetes. In: Cardiovascular Research. 1997 ; Vol. 34, No. 1. pp. 185-191.
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AU - Leuzzi, Stefano

AU - Mevio, Emilio

AU - Fornasari, Gabriele

AU - Calciati, Alessandro

AU - Orlandi, Cesare

AU - Fratino, Pietro

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N2 - Objective: Loss of spontaneous fluctuations in resting microcirculatory flow has been described in diabetes mellitus, but its mechanism remains unexplained. Methods: The autonomic control of forearm skin microcirculation was investigated in 23 insulin-dependent diabetic human subjects (median age 39 years, range 27-50) and in 23 age matched controls (median age 38 years, range 20-57), by laser-Doppler flowmetry. Using spectral analysis of spontaneous microvascular fluctuations, we measured the power of 0.1 Hz ('10- second rhythm') fluctuations, dependent on sympathetic control and of respiration-related, high-Frequency fluctuations, due to the transmission of mechanical chest activity. Autonomic function abnormalities were assessed by 5 tests of cardiovascular reflexes. Results: Abnormalities in cardiovascular autonomic tests were present in 7/23 patients: deep breathing was abnormal 4 in patients standing in 2, handgrip in 3, cross-correlation in 4 and Valsalva ratio in 0. The power of 0.1 Hz micro, circulatory fluctuations was significantly lower in diabetic than in control subjects (2.57 ± 0.16 vs 3.48 ± 0.09 In-mV2, mean ± s.e.m., P <0.001), whereas that of respiratory fluctuations was similar (2.60 ± 0.24 vs 2.56 ± 0.19 In-mV2. P=n.s.). The 0.1 Hz power was 2 standard deviations below the mean of controls (P <0.05) in 13/23 diabetic patients; this abnormality was significantly more frequent than abnormalities in any other autonomic test (P <0.001). Conclusions: Since the observed reduction was confined to those microvascular fluctuations trader autonomic control, but not to those dependent on passive mechanical transmission, the reduction in spontaneous microcirculatory vasomotion appears to he determined mainly by sympathetic dysfunction. Sympathetic impairment of skin microvascular control seems to be a common finding, and is probably an early index of autonomic dysfunction in insulin-dependent diabetes.

AB - Objective: Loss of spontaneous fluctuations in resting microcirculatory flow has been described in diabetes mellitus, but its mechanism remains unexplained. Methods: The autonomic control of forearm skin microcirculation was investigated in 23 insulin-dependent diabetic human subjects (median age 39 years, range 27-50) and in 23 age matched controls (median age 38 years, range 20-57), by laser-Doppler flowmetry. Using spectral analysis of spontaneous microvascular fluctuations, we measured the power of 0.1 Hz ('10- second rhythm') fluctuations, dependent on sympathetic control and of respiration-related, high-Frequency fluctuations, due to the transmission of mechanical chest activity. Autonomic function abnormalities were assessed by 5 tests of cardiovascular reflexes. Results: Abnormalities in cardiovascular autonomic tests were present in 7/23 patients: deep breathing was abnormal 4 in patients standing in 2, handgrip in 3, cross-correlation in 4 and Valsalva ratio in 0. The power of 0.1 Hz micro, circulatory fluctuations was significantly lower in diabetic than in control subjects (2.57 ± 0.16 vs 3.48 ± 0.09 In-mV2, mean ± s.e.m., P <0.001), whereas that of respiratory fluctuations was similar (2.60 ± 0.24 vs 2.56 ± 0.19 In-mV2. P=n.s.). The 0.1 Hz power was 2 standard deviations below the mean of controls (P <0.05) in 13/23 diabetic patients; this abnormality was significantly more frequent than abnormalities in any other autonomic test (P <0.001). Conclusions: Since the observed reduction was confined to those microvascular fluctuations trader autonomic control, but not to those dependent on passive mechanical transmission, the reduction in spontaneous microcirculatory vasomotion appears to he determined mainly by sympathetic dysfunction. Sympathetic impairment of skin microvascular control seems to be a common finding, and is probably an early index of autonomic dysfunction in insulin-dependent diabetes.

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