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Autonomic testing: which value for each cardiovascular test? An observational study

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A Letter to the Editor to this article was published on 08 February 2019

Abstract

Aims

Cardiovascular autonomic testing is time consuming when adopting the entire Ewing battery of tests, hence, clinicians usually adopt an empirically reduced number of tests which may give controversial results. Our purpose was to examine the reliability of the cardiovascular tests most commonly used in autonomic diagnoses.

Methods

We tested 334 subjects, from an original group of 3745, who had shown an altered deep breathing test to both Lying to standing and Valsalva manoeuvre, assuming a value of postural hypotension of more than 15 mmHg as a sign of almost true dysautonomia.

Results

VM showed the highest sensitivity (85%) and, when coupled to LS, highest specificity (83%).

Conclusions

VM could be useful when screening for possible or early autonomic neuropathy, VM + LS is useful as a diagnostic tool for probable or advanced autonomic neuropathy, and VM + LS + PH is useful for certain diagnosis of definite or late stage autonomic neuropathy.

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Authors and Affiliations

  1. Endocrinology and Diabetes section “Rizzola” Foundation Hospital, San Donà, Venezia, Italy

    Federico Bellavere

  2. Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy

    Eugenio Ragazzi

  3. Department of Medicine, University of Padova, Diabetology and Dietetics, ULSS 6 Euganea, via dei Colli, 35143, Padova, Italy

    Nino Cristiano Chilelli, Annunziata Lapolla & Giuseppe Bax

Authors
  1. Federico Bellavere
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  2. Eugenio Ragazzi
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  3. Nino Cristiano Chilelli
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  4. Annunziata Lapolla
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  5. Giuseppe Bax
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Corresponding author

Correspondence to Giuseppe Bax.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the institutional guidelines and therefore the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Written informed consent was obtained from all the study participants prior to their inclusion in the study.

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Managed by Antonio Secchi.

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Bellavere, F., Ragazzi, E., Chilelli, N.C. et al. Autonomic testing: which value for each cardiovascular test? An observational study. Acta Diabetol 56, 39–43 (2019). https://doi.org/10.1007/s00592-018-1215-y

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  • DOI: https://doi.org/10.1007/s00592-018-1215-y

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