Screening for cardiovascular autonomic neuropathy using SUDOSCAN®
Yun-Ru Lai, Chih-Cheng Huang, Ben-Chung Cheng, Nai-Wen Tsai, Wen-Chan Chiu, Hsueh-Wen Chang, Jung-Fu Chen, Cheng-Hsien Lu.
Article title: Feasibility of combining heart rate variability and electrochemical skin conductance as screening and severity evaluation of cardiovascular autonomic neuropathy in type 2 diabetes.
Muscle Nerve. 2021 Apr 1
YR Lai and colleagues from various medical institutions in Taiwan conducted a clinical study to investigate whether combining heart rate variability (HRV) and electrochemical skin conductance (ESC) measured with SUDOSCAN® can improve the accuracy of cardiovascular autonomic neuropathy (CAN) screening and provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already developed CAN in outpatient clinics. The study involved 90 T2DM patients, and the results showed that those with more severe CAN had higher CAN score values and lower values in feet ESC and HRV (SDNN*) (P<0.0001 and P=0.023, respectively). Multiple linear regression analysis also revealed that feet ESC and SDNN value (P=0.003 and P<0.0001, respectively) were significantly associated with CAN score. Combining HRV and feet ESC improved the diagnostic accuracy of CAN by increasing sensitivity and specificity according to receiver operating characteristic analysis (as shown in a table).
(*SDNN measures the standard deviation of normal RR interval, which is a measure of the time domain of HRV.)
Combining the results of HRV measurement and feet ESC can not only assess, but also quantitatively reflect the progress or improvement of autonomic nerve function (including sympathetic and parasympathetic activity) in patients with type 2 diabetes.
Sensitivity, specificity, and area under the curve using receiver operating characteristic curve analysis for SDNN, feet electrochemical skin conductance, as well as their combinations in predicting cardiovascular autonomic neuropathy.
*=p<0.05; **p<0;01; Abbreviation: ROC, receiver operating characteristic; ESC, electrochemical
skin conductance; SDNN standard deviation of normal RR interval
Φ=The positive or negative test results of feet ESC, SDDN, and its combination were according to cut-off value of each test in ROC analysis.
The false negative rate of the diagnosis of CAN by feet ESC, SDNN, and its combination were 40.7% (22/54), 27.8% (15/54) and 18.5% (10/54), respectively.
Keywords: cardiovascular autonomic neuropathy, electrochemical skin conductance, ESC, SUDOSCAN, heart rate variability, HRV.
Article available here.
