C Brock1,2,3, N Jessen4,5,6, B Brock4,7, P E Jakobsen8, T K Hansen9, J M Rantanen10,11, S Riahi12, Y K Dimitrova1, A Dons-Jensen9, Q Aziz13, A M Drewes1, A D Farmer1,13,14. 1. Department of Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark. 2. Department of Pharmacotherapy and Development, University of Copenhagen, Copenhagen. 3. Department of Rheumatology, Aarhus University Hospital, Aarhus. 4. Department of Clinical Medicine, Aarhus University Hospital, Aarhus. 5. Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus. 6. Department of Biomedicine, Aarhus University Hospital, Aarhus. 7. Department of Biochemistry, Aarhus University Hospital, Aarhus. 8. Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. 9. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus. 10. Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark. 11. Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark. 12. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. 13. Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, London School of Medicine and Dentistry, Queen Mary University of London, London. 14. Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, Staffordshire, UK.
Abstract
AIMS: To compare a novel index of parasympathetic tone, cardiac vagal tone, with established autonomic variables and to test the hypotheses that (1) cardiac vagal tone would be associated with established time and frequency domain measures of heart rate and (2) cardiac vagal tone would be lower in people with Type 1 diabetes than in a matched healthy cohort and lower still in people with established neuropathy. METHODS: Cardiac vagal tone is a validated cardiometrically derived index of parasympathetic tone. It is measured using a standard three-lead electrocardiogram which connects, via Bluetooth, to a smartphone application. A 5-min resting recording of cardiac vagal tone was undertaken and observational comparisons were made between 42 people with Type 1 diabetes and peripheral neuropathy and 23 without peripheral neuropathy and 65 healthy people. In those with neuropathy, 24-h heart rate variability values were compared with cardiac vagal tone. Correlations between cardiac vagal tone and clinical variables were also made. RESULTS: Cardiac vagal tone was lower in people with established neuropathy and Type 1 diabetes in comparison with healthy participants [median (interquartile range) linear vagal scale 3.4 (1.6-5.5 vs 7.0 (5.5-9.6); P < 0.0001]. Cardiac vagal tone was positively associated with time (r = 0.8, P < 0.0001) and frequency domain markers of heart rate variability (r = 0.75, P < 0.0001), representing established measures of parasympathetic function. Cardiac vagal tone was negatively associated with age (r=-0.32, P = 0.003), disease duration (r=-0.43, P < 0.0001) and cardiovascular risk score (r=-0.32, P = 0.006). CONCLUSIONS: Cardiac vagal tone represents a convenient, clinically relevant method of assessing parasympathetic nervous system tone, potentially facilitating the earlier identification of people with Type 1 diabetes who should undergo formal autonomic function testing.
AIMS: To compare a novel index of parasympathetic tone, cardiac vagal tone, with established autonomic variables and to test the hypotheses that (1) cardiac vagal tone would be associated with established time and frequency domain measures of heart rate and (2) cardiac vagal tone would be lower in people with Type 1 diabetes than in a matched healthy cohort and lower still in people with established neuropathy. METHODS: Cardiac vagal tone is a validated cardiometrically derived index of parasympathetic tone. It is measured using a standard three-lead electrocardiogram which connects, via Bluetooth, to a smartphone application. A 5-min resting recording of cardiac vagal tone was undertaken and observational comparisons were made between 42 people with Type 1 diabetes and peripheral neuropathy and 23 without peripheral neuropathy and 65 healthy people. In those with neuropathy, 24-h heart rate variability values were compared with cardiac vagal tone. Correlations between cardiac vagal tone and clinical variables were also made. RESULTS: Cardiac vagal tone was lower in people with established neuropathy and Type 1 diabetes in comparison with healthy participants [median (interquartile range) linear vagal scale 3.4 (1.6-5.5 vs 7.0 (5.5-9.6); P < 0.0001]. Cardiac vagal tone was positively associated with time (r = 0.8, P < 0.0001) and frequency domain markers of heart rate variability (r = 0.75, P < 0.0001), representing established measures of parasympathetic function. Cardiac vagal tone was negatively associated with age (r=-0.32, P = 0.003), disease duration (r=-0.43, P < 0.0001) and cardiovascular risk score (r=-0.32, P = 0.006). CONCLUSIONS: Cardiac vagal tone represents a convenient, clinically relevant method of assessing parasympathetic nervous system tone, potentially facilitating the earlier identification of people with Type 1 diabetes who should undergo formal autonomic function testing.
Authors: James K Ruffle; Steven J Coen; Vincent Giampietro; Steven C R Williams; A Vania Apkarian; Adam D Farmer; Qasim Aziz Journal: Hum Brain Mapp Date: 2017-10-28 Impact factor: 5.038
Authors: Anne-Marie Langmach Wegeberg; Christian Stevns Hansen; Adam D Farmer; Jesper Scott Karmisholt; Asbjorn M Drewes; Poul Erik Jakobsen; Birgitte Brock; Christina Brock Journal: United European Gastroenterol J Date: 2020-05-09 Impact factor: 4.623
Authors: James K Ruffle; Anya Patel; Vincent Giampietro; Matthew A Howard; Gareth J Sanger; Paul L R Andrews; Steven C R Williams; Qasim Aziz; Adam D Farmer Journal: J Physiol Date: 2019-02-27 Impact factor: 5.182
Authors: Elena Daskalaki; Anne Parkinson; Nicola Brew-Sam; Md Zakir Hossain; David O'Neal; Christopher J Nolan; Hanna Suominen Journal: J Med Internet Res Date: 2022-04-08 Impact factor: 7.076
Authors: James K Ruffle; Steven J Coen; Vincent Giampietro; Steven C R Williams; Qasim Aziz; Adam D Farmer Journal: Sci Rep Date: 2018-09-07 Impact factor: 4.379
Authors: Christina Brock; Christian Stevns Hansen; Jesper Karmisholt; Holger Jon Møller; Anne Juhl; Adam Donald Farmer; Asbjørn Mohr Drewes; Sam Riahi; Hans Henrik Lervang; Poul Erik Jakobsen; Birgitte Brock Journal: Br J Clin Pharmacol Date: 2019-08-30 Impact factor: 4.335
Authors: Anne-Marie L Wegeberg; Tina Okdahl; Tina Fløyel; Christina Brock; Niels Ejskjaer; Sam Riahi; Flemming Pociot; Joachim Størling; Birgitte Brock Journal: Mediators Inflamm Date: 2020-08-18 Impact factor: 4.711
Authors: C Brock; S E Rasmussen; A M Drewes; H J Møller; B Brock; B Deleuran; A D Farmer; M Pfeiffer-Jensen Journal: Mediators Inflamm Date: 2021-05-27 Impact factor: 4.711
Authors: Othmar Moser; Gerhard Tschakert; Alexander Mueller; Werner Groeschl; Max L Eckstein; Gerd Koehler; Richard M Bracken; Thomas R Pieber; Peter Hofmann Journal: Front Endocrinol (Lausanne) Date: 2018-10-02 Impact factor: 5.555