Cardiac Autonomic Neuropathy Screening is a clinical assessment protocol designed to detect damage or dysfunction in the autonomic nerves specifically controlling heart rate and blood pressure regulation. This screening is crucial for identifying early subclinical changes, particularly in individuals with chronic metabolic conditions such as diabetes or significant hormonal imbalances. The presence of Cardiac Autonomic Neuropathy (CAN) signals a profound disruption in the neurovisceral axis, elevating the risk for cardiovascular events and all-cause mortality. Early detection allows for targeted interventions to mitigate disease progression and improve overall physiological resilience.
Origin
The methodology originates from decades of cardiovascular and neurological research, initially focusing on complications observed in long-standing diabetes mellitus. It involves a battery of standardized, non-invasive tests that provoke specific autonomic reflexes to quantify the heart’s response. The term ‘screening’ emphasizes its role as a proactive, early-stage diagnostic tool rather than a late-stage confirmation of established pathology.
Mechanism
Screening typically involves evaluating heart rate variability (HRV) responses to maneuvers like deep breathing, the Valsalva maneuver, and changes in posture (orthostatic challenge). These tests assess the integrity of both the parasympathetic (vagal) and sympathetic efferent pathways to the heart. Diminished or absent responses indicate autonomic nerve fiber damage, which compromises the body’s ability to dynamically regulate cardiac function. This neurological deficit has significant implications for systemic homeostasis, often co-existing with or exacerbating hormonal dysregulation, particularly involving catecholamines and insulin sensitivity.
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