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PubMed2005

Cardiac autonomic dysfunction in rats chronically treated with anabolic steroid.

To date no published data exist regarding the effects of chronic high-dose anabolic-androgenic steroid administration on tonic cardiac autonomic control. The aim of this study was to evaluate, by power spectral analysis of heart rate variability (HRV), the effects of chronic treatment with supraphysiological doses of nandrolone decanoate (DECA) on tonic cardiac autonomic regulation in sedentary rats. Male Wistar rats were treated weekly with 10 mg kg(-1) of DECA (n=7) or vehicle (CONTROL, n=7) for 10 weeks. At the 8th week of treatment, electrocardiogram was recorded in the conscious state, for time- and frequency-domain HRV analysis. Parasympathetic indexes were reduced in DECA group: high-frequency power (CONTROL=11.1+/-3.0 ms2 vs. DECA=3.8+/-0.6 ms2, P<0.05), RMSSD (CONTROL=5.9+/-0.9 ms vs. DECA 3.5+/-0.3 ms; P<0.05) and pNN5 (CONTROL=31.5+/-7.5 ms vs. DECA=13.2+/-2.6 ms; P<0.05). The sympathetic index LF/HF tended to be higher in DECA group (CONTROL=0.65+/-0.15 vs. DECA=1.17+/-0.26, P=0.0546). In conclusion, chronic treatment with DECA, in rats, impairs tonic cardiac autonomic regulation, which may provide a key mechanism for anabolic steroid-induced arrhythmia and sudden cardiac death.

Anabolic Agents↗
PubMed1999

Prospective evaluation of autonomic dysfunction in aggressive management of diabetic microangiopathy.

Twenty-six type I diabetic nephropathy patients in a rigorous schedule for glucose control to preserve kidney function were studied to determine autonomic functional changes during 18 months. Intercurrent and nonrelated acute illness, withdrawal from the study for personal reasons, or failure to undergo testing on schedule resulted in complete data at 1 year for 26 of the original 41 patients enrolled, 24 patients completing a further 6 months. Glycohemoglobin A1c dropped for the total group from 9.0 to 7.9 at 6 months, 8.0 at 12 months, and 8.1 at 18 months (P<.01). Autonomic function tests revealed baseline results that were below the anticipated normals for age in 38% to 56% of patients. Timed ventilatory heart rate variations measured for the total group were 1.11, 1.13, 1.10, and 1.09 (normal > or =1.20). Valsalva heart rate variations for the total group were 1.27, 1.30, 1.255, and 1.35 (normal > or =1.50). Assumption of upright posture-related heart rate variations for the total group were 1.10, 1.07, 1.07, and 1.06 (normal > or =1.20). Mean arterial pressure day/night ratios for the total group were 1.04, 1.05, 1.05, and 1.08 (normal > or =1.10). Group analysis based on differences in insulin treatment programs, levels of blood pressure, and levels of renal function revealed no significant differences from the total group or companion groups during 18 months. Patients with a glycohemoglobin A1c of <8.0% were more likely to normalize mean arterial pressure day/night ratios than those with glycohemoglobin A1c > or =8.0%. We conclude that aggressive glucose control in diabetic patients with proteinuria for a period of 18 months resulted in a reproducible pattern of autonomic function tests during that period of time with neither worsening nor improvement. The restoration of day/night mean arterial pressure variation in a minority of patients should be studied with a larger cohort.

Adult↗
PubMed2004

[The diagnosis of an autonomic dysfunction of the lower limb as a major aspect of the neurological investigation and risk assessment of a diabetic foot syndrome].

Sensomotoric diabetic polyneuropathy is often associated with damage to autonomic nerve fibers. In the case of the lower extremity, this manifests in the form of a sudomotoric and/or vasomotoric disorder. This in turn is believed to be closely related to the development of neurotrophic ulcerations of the foot. The sudomotoric disorder leads to anhidrosis of the skin of the foot, leading to the formation of rhagades and fissures. Neurovascular problems with disordering of microvascular perfusion and trophic disturbances then become risk factors for foot ulcers, in particular when skin traumata occur in addition. Various methods for identifying an autonomic function disturbance in the lower limb are based either on the measurement of sweat secretion or on the investigation of peripheral microvascular function. A purposeful assessment of risk and prevention of neurotrophic damage in the lower limb is possible only on the basis of a rigorous differential diagnostic work-up of the diabetic polyneuropathy.

Autonomic Nervous System Diseases↗