Author/Editor		Žvan, Bojana; Zaletel, Marjan; Pretnar-Oblak, Janja; Pogačnik, Tomaž; Kiauta, Tomaž
Title		The middle cerebral artery flow velocities during head-up tilt testing in diabetic patients with autonomic nervous system dysfunction
Type		članek
Source		Cerebrovasc Dis
Vol. and No.		Letnik 15
Publication year		2003
Volume		str. 270-5
Language		eng
Abstract		Background: The goal of this study was to examine the effects of diabetes mellitus on the trend of mean arterial velocity (vm) in both middle cerebral arteries during head-uptilt (HUT). Methods: The studywas performed in 20 patients, 9 females and 11 males (mean age 51 +- 12 years) with an average 17-year history of insulin-dependent diabetes mellitus type I or II and a dysfunction of the autonomic nervous system confirmed by cardiocirculatory tests [Valsalva maneuver, deep breathing test, handgrip test, orthostatic test and spectral analysis of heart rate (HR) variability], and 19 age-matched healthy volunteers, 9 females and 10 males (mean age 48 +- 6.8 years). vm was measured by a transcranial Doppler monitoring system during a 5-min baseline period, followed by a 5-min HUT in the upright position (90°). Mean arterial blood pressure (MAP), HR and end-tidal CO2 (Et-CO2) were monitored concomitantly. Results: In healthy volunteers, vm decreased stepwise during the first minu of HUT, reaching a minimum during the last 2 min of the test (vm: basal 63.0 +- 11.7 cm/s, 1st min 57.6 +- 12.2 cm/s, 2nd min 55.9 +- 12.6 cm/s, 3rd min 53.4 +- 12.6 cm/s, 4th min 52.1 +- 12.7 cm/s, 5th min 51.3 +- 13.5 cm/s). In the supine position, vm recovered and reached the resting vm values. It declined gradually during HUT and less steeply in diabetic (vm: basal 54.4 +- 10.1 cm/s, 1st min 51.96 +- 9.3 cm/s, 2nd min 50.7 +- 11.6 cm/s, 3rd min 50.5 +- 11.4 cm/s, 4th min 49.5 +- 10.7 cm/s, 5th min 48.8 +- 11.5 cm/s) than in healthy subjects. vm differed significantly (p = 0.00) between rest and HUT in both groups. The differences in MAP, HR and Et-CO2 during rest and HUT between the groups were not statistically significant (p deltaMAP = 0.36, p deltaHR = 0.86, p deltaEt-CO2 = 0.97). The results of the analysis of variance of vm for repeated measurements between the two groups of subjects were highly significant (p = 0.00). (Abstract truncated at 2000 characters).
Descriptors		CEREBRAL ARTERIES TILT-TABLE TEST BLOOD FLOW VELOCITY DIABETES MELLITUS, INSULIN-DEPENDENT DIABETES MELLITUS, NON-INSULIN-DEPENDENT AUTONOMIC NERVOUS SYSTEM DISEASES VALSALVA'S MANEUVER HAND STRENGTH HEART RATE ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL BLOOD PRESSURE CAPNOGRAPHY