Early diagnosis of diabetic cardiac autonomic neuropathy by method of high-frequency ultrasonic dopplerography
https://doi.org/10.24884/1682-6655-2019-18-2-49-57
Abstract
Introduction. Diabetic neuropathy is the most wide-spread complication of diabetes mellitus and neuropathy is steadily progressing even with compensation of the underlying disease. The search of the new methods of treatment and diagnosis of neuropathy is required. Diabetic autonomic neuropathy lies in the base of early morbidity and mortality of diabetic patients.
We estimated the potential of High-frequency Ultrasonic Dopplerography for diagnosis of autonomic neuropathy. Material and methods. 26 diabetic patients with sensorimotor neuropathy were examined. Microvascular blood flow of finger skin was assessed at rest as well as in functional tests: with cold impact and occlusion (cuff). Cardiac autonomic neuropathy was assessed using several cardiovascular autonomic reflex tests as a gold standard of diagnosis. Diagnostic values of microvascular blood flow test in detecting of cardiac autonomic neuropathy staging were evaluated in comparing with traditional modalities.
Results. Cardiac autonomic neuropathy was found for all patients and definite/confirmed staging in 61.5 % cases. Initial parameters of microvascular blood flow velocity were significantly decreased in all patients in comparing with control (Vam= = (1.9±0.22); (1.7±0.51) and (6.7±0.51) sm/s in patients with early cardiac autonomic neuropathy, definite/confirmed staging and control subjects respectively, p<0.05). Microvascular blood flow functional testes had great informational content for diagnosis of autonomic neuropathy (sensitivity – 100 and 58 %, specify – 50 and 80 % respectively). The algorithm of diabetic patients examination was offered for early diagnosis of autonomic neuropathy staging.
Conclusions. High-frequency Ultrasonic Dopplerography allowed to separate of cardiac autonomic neuropathy stages. This study is necessary to continue for revealing of all method possibilities.
About the Authors
T. A. Zelenina
Military Medical Academy named after S. M. Kirov
Russian Federation
Zelenina Tatiana Alexandrovna – MD, PhD, endocrinologist, diabetologist of the Clinical Medical Center
Russian Federation
Zelenina Tatiana Alexandrovna – MD, PhD, endocrinologist, diabetologist of the Clinical Medical Center
V. V. Salukhov
Military Medical Academy named after S. M. Kirov
Russian Federation
Salukhov Vladimir Vladimirovich – MD, Doctor of Medicine, Head of Department of Postgraduate Therapy Education № 1
Russian Federation
Salukhov Vladimir Vladimirovich – MD, Doctor of Medicine, Head of Department of Postgraduate Therapy Education № 1
E. A. Volkova
North-Western State Medical University named after I. I. Mechnikov
Russian Federation
Volkova Elena Alexandrovna – MD, PhD, Associate Professor
Russian Federation
Volkova Elena Alexandrovna – MD, PhD, Associate Professor
A. B. Zemlynoj
National Medical and Surgical Center named after N. I. Pirogov
Russian Federation
Zemlynoj Alexandr Borisovich – MD, Doctor of Medicine, Professor of Surgical Infections Department
Russian Federation
Zemlynoj Alexandr Borisovich – MD, Doctor of Medicine, Professor of Surgical Infections Department
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For citations:
Zelenina T.A., Salukhov V.V., Volkova E.A., Zemlynoj A.B. Early diagnosis of diabetic cardiac autonomic neuropathy by method of high-frequency ultrasonic dopplerography. Regional blood circulation and microcirculation. 2019;18(2):49-57. (In Russ.) https://doi.org/10.24884/1682-6655-2019-18-2-49-57
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