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An approach for Ewing test selection to support the clinical assessment of cardiac autonomic neuropathy

Andrew Stranieri, Jemal Abawajy, Andrei Kelarev, Shamsul Huda, Morshed Chowdhury, Herbert F. Jelinek
2013 Artificial Intelligence in Medicine  
In this paper, we use data mining methods to find optimal sequences of tests for the clinical risk assessment of cardiac autonomic neuropathy (CAN), prepare outcomes required for determination of optimal  ...  Conclusion We have applied decision trees to the problem of supporting clinicians in finding optimal sequences of tests for each individual patient for the assessment of cardiac autonomic neuropathy.  ... 
doi:10.1016/j.artmed.2013.04.007 pmid:23768975 fatcat:2om7tbssyjfqnhdjhgxbxrexqa

Machine Learning Methods for Automated Detection of Severe Diabetic Neuropathy

Herbert F Jelinek, David J Cornforth, Andrei V Kelarev
2016 Journal of Diabetic Complications & Medicine  
Severe diabetic neuropathy represents a significant neurological problem in diabetes as it requires urgent intervention to reduce the risk of sudden cardiac death.  ...  This method is intended to enhance the effectiveness of the diagnosis of severe diabetic neuropathy.  ...  Acknowledgement The authors wish to acknowledge the technical assistance of Bev de Jong and Paul Reidler for collecting the Ewing data.  ... 
doi:10.4172/2475-3211.1000108 fatcat:5udibzc5jbdtxpwrvz5idexqmi

Noninvasive exploration of Cardiac Autonomic Neuropathy by heart rate and blood pressure variability analysis in Type 2 Diabetic patients

Tallat Naz, Noor Un Nisa Memon, Kamran Afzal, Ambreen Shakir
2021 Pakistan Journal of Medical Sciences  
To determine the prevalence of asymptomatic cardiac autonomic neuropathy and its association with risk factors among patients with Type-2 diabetes mellitus (T2DM).  ...  After taking medical history and demographics, Cardiac Autonomic Neuropathy (CAN) was identified by using Ewing's cardiac autonomic reflex tests (CARTs) and association of risk factors was also investigated  ...  Source of funding: Self-financed.  ... 
doi:10.12669/pjms.37.4.3675 pmid:34290776 pmcid:PMC8281166 fatcat:q7u4ptnr6vcsboe6bhbvx2nf3a

The detection of early myocardial changes in asymptomatic diabetic individuals by 99mTc – Myoview gated-SPET and heart rate variability measurement

M. Migra, M. Knazeje, M. Ochodnicky, F. Kovar, A. Lacko, M. Mokan
2014 Bratislava Medical Journal  
In the present study, we examined diabetic patients without a history of cardiovascular disease with negative treadmill test and no signs of systolic dysfunction for presence of cardiac autonomic neuropathy  ...  Diagnosis of cardiac autonomic neuropathy based on Ewing´s testing and HRV examination was established in 60 % of T1DM patients (p=0.001) and 77 % of T2DM patients (p=0.001).  ...  According to the current guidelines of European Society of Cardiology, a positive SPET fi nding without clinical or ECG signs of subendocardial ischemia is not an indication for selective coronary angiography  ... 
doi:10.4149/bll_2014_045 fatcat:wouq7h3x6faxpg6hulydmywj6u

Heartbeat and arrhythmia perception in diabetic autonomic neuropathy

Paul Pauli, Lydia Hartl, Christian Marquardt, Henrica Stalmann, Friedrich Strian
1991 Psychological Medicine  
In the subjects with diabetic autonomic neuropathy, the spontaneaus variability and stress-induced reactivity of the heart rate as weil as the number of tachycardic episodes were reduced, whereas the frequency  ...  Cardiac perception disordersalso playavital roJe in other clinical problems, e.g. silent myocardial infarction and Iack of awareness of hypoglycaemia in diabetes mellitus.  ...  Cardiac perception in diabetic autonomic neuropathy was assessed with a hea t (mental) tracking task and an arrhythmi r beat ception task.  ... 
doi:10.1017/s0033291700020523 fatcat:ct6sdsgirne4hgu4n75unxtoha

Sudden cardiac death in diabetes mellitus: risk factors in the Rochester diabetic neuropathy study

G A Suarez
2005 Journal of Neurology, Neurosurgery and Psychiatry  
Objectives: To determine risk factors for sudden cardiac death and the role of diabetic autonomic neuropathy (DAN) in the Rochester diabetic neuropathy study (RDNS) Methods: Associations between diabetic  ...  Medical records, death certificates, and necropsy reports were assessed for causes of sudden cardiac death. Results: 21 cases of sudden cardiac death were identified over 15 years of follow up.  ...  The database from the RDNS has been used to develop and assess neuropathy tests, composite scores, and a staging approach, 9 the prevalence of diabetic complications, 8 progression, 10 and risk factors  ... 
doi:10.1136/jnnp.2004.039339 pmid:15654040 pmcid:PMC1739480 fatcat:kl4ypgxjsncglp5atdiukmz2pa

Identifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis

Ahsan H Khandoker, Herbert F Jelinek, Marimuthu Palaniswami
2009 BioMedical Engineering OnLine  
Early sub clinical detection of CAN and intervention are of prime importance for risk stratification in preventing sudden death due to silent myocardial infarction.  ...  Cardiac autonomic neuropathy (CAN) in diabetes has been called a "silent killer", because so few patients realize that they suffer from it, and yet its effect can be lethal.  ...  Acknowledgements This work was partially supported by an Australian Research Council (ARC) Linkage grant (LP0454378) awarded to MP and an early career grant awarded to AHK by University of Melbourne.  ... 
doi:10.1186/1475-925x-8-3 pmid:19178728 pmcid:PMC2645418 fatcat:at6ipoda3bffdjwviriw4md6he

Exercise based assessment of cardiac autonomic function in type 1 versus type 2 diabetes mellitus

Jeffrey J. Goldberger, Daniel J. Pelchovitz, Jason Ng, Haris Subacius, Alexandru B. Chicos, Smriti Banthia, Mark Molitch, Ronald B. Goldberg
2020 Cardiology Journal  
Cardiac autonomic neuropathy (CAN) is a complication of diabetes mellitus (DM) that is associated with increased mortality.  ...  The variable pathophysiology for exercise-induced autonomic abnormalities in type 1 versus type 2 DM may impact prognosis.  ...  Subjects with diabetes had no clinical evidence of peripheral or autonomic neuropathy and had low overall scores on CAN testing (Ewing score 0.8 ± 0.8 for type 1 DM and 1.2 ± 0.9 for type 2 DM, p = NS)  ... 
doi:10.5603/cj.a2020.0064 pmid:32378730 pmcid:PMC9007477 fatcat:kvelrwme25aojeb674rpvodqzi

Cardiac Autonomic Neuropathy in Diabetes: A clinical perspective

R. Pop-Busui
2010 Diabetes Care  
A clinical perspective RODICA POP-BUSUI, MD, PHD T his review covers the epidemiology, pathophysiology, clinical presentation, and diagnosis of cardiac autonomic neuropathy (CAN) in diabetes and discusses  ...  current evidence on approaches to prevention and treatment of CAN.  ...  the clinical assessment of CAN in the future.  ... 
doi:10.2337/dc09-1294 pmid:20103559 pmcid:PMC2809298 fatcat:uk6udqq24ncgjnor3uhztskua4

Screening cardiovascular autonomic neuropathy in diabetic patients with microvascular complications using machine learning: a 24-hour heart rate variability study

Mohanad Alkhodari, Mamunur Rashid, Mohammad Abdul Mukit, Khawza I. Ahmed, Raqibul Mostafa, Sharmin Parveen, Ahsan H. Khandoker
2021 IEEE Access  
The approach is considered to be simple and effective, especially for under-resourced clinical settings.  ...  Cardiovascular autonomic neuropathy (CAN) is one of the most overlooked complications associated with diabetes.  ...  The current gold standard approach to diagnose and assess CAN patients is to perform five Ewing cardiac reflex tests [12] .  ... 
doi:10.1109/access.2021.3107687 fatcat:wpesjnf6jzhojk26lqqkkanx2e

Cardiac Autonomic Neuropathy in Diabetes Mellitus

Shruti Agashe, Steven Petak
2018 Methodist DeBakey Cardiovascular Journal  
Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function.  ...  Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes.  ...  As clinical CAN progresses, orthostatic hypotension becomes apparent. 5, 18, 20 The standard CARTs may be used to obtain an autonomic neuropathy score to assess the severity of CAN and monitor its progression  ... 
doi:10.14797/mdcj-14-4-251 pmid:30788010 pmcid:PMC6369622 fatcat:uxgut4mje5eldlgofa4tdu36f4

Diabetic Autonomic Neuropathy

A. I. Vinik, R. E. Maser, B. D. Mitchell, R. Freeman
2003 Diabetes Care  
Cardiovascular autonomic neuropathy (CAN) is the most studied and clinically important form of DAN.  ...  A complete workup for erectile dysfunction in men should include history (medical and sexual); psychological evaluation; hormone levels; measurement of nocturnal penile tumescence; tests to assess penile  ...  In all 15 studies, the baseline assessment for cardiovascular autonomic function was made on the basis of one or more of the tests described by Ewing et al. (95) .  ... 
doi:10.2337/diacare.26.5.1553 pmid:12716821 fatcat:avkdtwvgubbjzm2rxb3al27zfq

The prevalence of cardiac autonomic neuropathy in prediabetes: a systematic review

Aikaterini Eleftheriadou, Scott Williams, Sarah Nevitt, Emily Brown, Rebecca Roylance, John P. H. Wilding, Daniel J. Cuthbertson, Uazman Alam
2020 Diabetologia  
Aims/hypothesis Cardiac autonomic neuropathy (CAN) is independently associated with silent myocardial ischaemia, major cardiovascular events, myocardial dysfunction and cardiovascular mortality.  ...  Six of the selected studies reported definite CAN prevalence data (9–39%).  ...  Acknowledgements We would like to acknowledge staff at the Edge Hill University Library, Clinical Sciences Centre, Aintree University Hospital for their support.  ... 
doi:10.1007/s00125-020-05316-z pmid:33164108 pmcid:PMC7801295 fatcat:x57ljrufazeuvoecmgjuqjav2e

The ECG Vertigo in Diabetes and Cardiac Autonomic Neuropathy

Christina Voulgari, Nicholas Tentolouris, Christodoulos Stefanadis
2011 Experimental Diabetes Research  
In this paper, the clinical and research value of the ECG is readdressed in diabetes and in the presence of cardiac autonomic neuropathy.  ...  The ECG offers a quick, noninvasive clinical and research screen for the early detection of cardiovascular disease in diabetes.  ...  Diagnostics Tests for the Assessment of Cardiac Autonomic Neuropathy The Golden Standard in clinical autonomic testing remains the cardiovascular reflex tests.  ... 
doi:10.1155/2011/687624 pmid:21747831 pmcid:PMC3124253 fatcat:nh2jeekrfjfyfcvs3lqzjhhzo4

Diabetic Cardiovascular Autonomic Neuropathy

A. I. Vinik, D. Ziegler
2007 Circulation  
Advances in technology, built on decades of research and clinical testing, now make it possible to objectively identify early stages of CAN with the use of careful measurement of autonomic function and  ...  of the most overlooked of all serious complications of diabetes is cardiovascular autonomic neuropathy (CAN), 1-3 which encompasses damage to the autonomic nerve fibers that innervate the heart and blood  ...  In all 15 studies, the baseline assessment for cardiovascular autonomic function was made on the basis of 1 or more of the tests described by Ewing et al. 35 Total mortality rates were higher in subjects  ... 
doi:10.1161/circulationaha.106.634949 pmid:17242296 fatcat:35po7dsz5vb7lblw6vaygcdlky
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