Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy

Massimo Pagani, Gabriella Malfatto, Simona Pierini, Rodolfo Casati, Anna Maria Masu, Massimo Poli, Stefano Guzzetti, Federico Lombardi, Sergio Cerutti, Alberto Malliani

Research output: Contribution to journalArticlepeer-review


We studied heart rate variability in 49 uncomplicated diabetics (27 with insulin therapy; 22 with oral hypoglycemic agents) and in 40 age-matched controls. An automatic autoregressive algorithm was used to compute the power spectral density (PSD) of beat by beat RR variability derived from the surface ECG. The PSD contains two major components (a low frequency ∼ 0.1 Hz (LF) and a high frequency, respiratory linked, ∼ 0.25 Hz (HF)) that provide, respectively, quantitative markers of sympathetic and vagal modulatory activities and of their balance. As compared to controls, in diabetics, besides a reduced RR variance at rest (2722 ± 300 and 1436 ± 241 ms2, respectively), we observed during passive tilt an altered response of spectral indices of sympathetic activation and vagal withdrawal, suggestive of a complex modification in the neural control activities. In addition, we compared this approach to the commonly used clinical tests score, and observed that the latter provides overall results similar to those obtained with spectral changes induced by tilt (r = 0.42; P <0.01). Of potential clinical importance is that the data obtained with spectral analysis appear more thoroughly quantifiable and do not require the active collaboration of the patients.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
JournalJournal of the Autonomic Nervous System
Issue number2
Publication statusPublished - 1988


  • Autonomic neuropathy
  • Computer analysis
  • Sympathetic activity
  • Vagal activity

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Neuroscience(all)


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