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Heartbeat and arrhythmia perception in diabetic autonomic neuropathy

Published online by Cambridge University Press:  09 July 2009

Paul Pauli ,
Lydia Hartl ,
Christian Marquardt ,
Henrica Stalmann  and
Friedrich Strian
Paul Pauli*
Affiliation:
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany
Lydia Hartl
Affiliation:
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany
Christian Marquardt
Affiliation:
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany
Henrica Stalmann
Affiliation:
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany
Friedrich Strian
Affiliation:
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany
*
1Address for correspondence: Dr Paul Pauli, Max-Planck-Institut für Psychiatrie, Neurologische Poliklinik, Kraepelinstr. 10, 8000 München 40, Germany.
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Synopsis

A comparative study of diabetics with autonomic neuropathy (N = 13) as against non-neuropathic diabetics (N = 16) and healthy control persons (N = 20) was carried out with respect to heart rate both at rest and under stress, frequency of cardiac arrhythmias in a 24-h ECG and accuracy of heartbeat and arrhythmia perception. In the subjects with diabetic autonomic neuropathy, the spontaneous variability and stress-induced reactivity of the heart rate as well as the number of tachycardic episodes were reduced, whereas the frequency of ventricular extrasystoles was somewhat increased. Impaired heartbeat perception and a complete loss of perception of arrhythmias as a consequence of neuropathic deafferentation could be demonstrated. Cardiac perception disorders also play a vital role in other clinical problems, e.g. silent myocardial infarction and lack of awareness of hypoglycaemia in diabetes mellitus.

Type
Original Articles
Information
Psychological Medicine , Volume 21 , Issue 2 , May 1991 , pp. 413 - 421
Copyright
Copyright © Cambridge University Press 1991

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