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System identification of closed-loop cardiovascular control mechanisms: diabetic autonomic neuropathyWe applied cardiovascular system identification (CSI) to characterize closed-loop cardiovascular regulation in patients with diabetic autonomic neuropathy (DAN). The CSI method quantitatively analyzes beat-to-beat fluctuations in noninvasively measured heart rate, arterial blood pressure (ABP), and instantaneous lung volume (ILV) to characterize four physiological coupling mechanisms, two of which are autonomically mediated (the heart rate baroreflex and the coupling of respiration, measured in terms of ILV, to heart rate) and two of which are mechanically mediated (the coupling of ventricular contraction to the generation of the ABP wavelet and the coupling of respiration to ABP). We studied 37 control and 60 diabetic subjects who were classified as having minimal, moderate, or severe DAN on the basis of standard autonomic tests. The autonomically mediated couplings progressively decreased with increasing severity of DAN, whereas the mechanically mediated couplings were essentially unchanged. CSI identified differences between the minimal DAN and control groups, which were indistinguishable based on the standard autonomic tests. CSI may provide a powerful tool for assessing DAN.
Document ID
20040142041
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Mukkamala, R.
(Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology Cambridge Massachusetts 02139, United States)
Mathias, J. M.
Mullen, T. J.
Cohen, R. J.
Freeman, R.
Date Acquired
August 22, 2013
Publication Date
March 1, 1999
Publication Information
Publication: The American journal of physiology
Volume: 276
Issue: 3 Pt 2
ISSN: 0002-9513
Subject Category
Life Sciences (General)
Funding Number(s)
CONTRACT_GRANT: 5-R01-HL39291
Distribution Limits
Public
Copyright
Other
Keywords
Non-NASA Center
NASA Discipline Regulatory Physiology

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