Published in:
01-01-2019 | Original Article
Autonomic testing: which value for each cardiovascular test? An observational study
Published in: Acta Diabetologica | Issue 1/2019
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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.