0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 50.17.176.149. Please contact the publisher to request reinstatement.
ARTICLE |

The Autonomous Heart in Diabetic Autonomic Neuropathy

Samuel Vaisrub, MD
JAMA. 1976;236(24):2784. doi:10.1001/jama.1976.03270250052032.
Text Size: A A A
Published online

When autonomic neuropathy involving the cardiovascular system of a diabetic patient is manifested by postural hypotension, it is easily recognizable. Much less obvious and less well known is the effect of the neuropathy on the regulation of the heart rate.

That this effect may be striking could be surmised from animal experiments1 and, more important, from the unique model of cardiac denervation provided by cardiac transplantation in the human. Griepp et al2 demonstrated that the heart rate increased only slightly during the initial phase of exercise in patients with transplanted hearts. A pronounced increase occurred later in exercise, presumably when catecholamines reached the heart after they had been released into the circulation from extracardiac sites. In some patients, the heart rate barely changed during maneuvers designed to stimulate or inhibit the autonomic nervous system.

Lloyd-Mostyn and Watkins3 recently reported a near-total nonsurgical cardiac denervation in a patient

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();