Is there a relationship between length-dependent sensorimotor polyneuropathy and tachycardia?

From the Guidelines

There is a significant relationship between length-dependent sensorimotor polyneuropathy and tachycardia, particularly when the polyneuropathy affects the autonomic nervous system, as evidenced by the presence of resting tachycardia in patients with cardiovascular autonomic neuropathy (CAN) 1.

Key Points to Consider

• Length-dependent sensorimotor polyneuropathy can progress to involve autonomic nerves, disrupting heart rate regulation and leading to tachycardia 1.
• Cardiovascular autonomic neuropathy (CAN) is a common complication of diabetic polyneuropathy, affecting up to 30% of patients, and can lead to resting tachycardia or an inability to adjust heart rate during physical activity.
• The relationship between polyneuropathy and tachycardia is not limited to diabetic polyneuropathy, as other conditions like amyloidosis, Guillain-Barré syndrome, and certain toxic neuropathies can also affect autonomic function and heart rate.
• Patients experiencing both polyneuropathy symptoms and unexplained tachycardia should be evaluated for possible autonomic involvement, with assessment including a careful history and evaluation of symptoms like orthostatic dizziness, syncope, or dry cracked skin in the extremities 1.
• Management of polyneuropathy-related tachycardia typically focuses on treating the underlying cause of the neuropathy while providing symptomatic relief, which may include medications like beta-blockers to control heart rate if tachycardia is problematic.

Clinical Implications

• Early recognition and appropriate management of neuropathy in people with diabetes is crucial to prevent complications like tachycardia and improve quality of life 1.
• Glycemic control can effectively prevent diabetic peripheral neuropathy (DPN) and cardiac autonomic neuropathy (CAN) in type 1 diabetes, and may modestly slow their progression in type 2 diabetes 1.
• Treatment of other modifiable risk factors, such as lipids and blood pressure, can aid in prevention of DPN progression in type 2 diabetes and may reduce disease progression in type 1 diabetes 1.

From the Research

Relationship Between Length-Dependent Sensorimotor Polyneuropathy and Tachycardia

• There is limited direct evidence linking length-dependent sensorimotor polyneuropathy and tachycardia, as the provided studies primarily focus on the diagnosis, management, and characteristics of sensorimotor polyneuropathies rather than their direct relationship with tachycardia.
• However, some studies suggest that autonomic dysfunction, which can include symptoms like tachycardia, is associated with sensorimotor polyneuropathies 2, 3.
• A study from 2007 found that familial amyloid polyneuropathies (FAP) patients manifest progressive sensory-motor length-dependent polyneuropathy and severe autonomic dysfunction, including symptoms like postural hypotension, nausea, and vomiting, but does not specifically mention tachycardia 2.
• Another study from 1981 investigated autonomic disturbances in relation to sensorimotor peripheral neuropathy in diabetes mellitus and found a weak correlation between autonomic disturbances and sensorimotor polyneuropathy, suggesting a multifactorial causation 3.
• A 2008 study on length-dependent diabetic polyneuropathy found that symptomatic autonomic dysfunction was present in 28 out of 30 patients, but does not provide specific information on tachycardia 4.
• Overall, while there is some evidence of autonomic dysfunction in patients with sensorimotor polyneuropathies, the direct relationship between length-dependent sensorimotor polyneuropathy and tachycardia is not well-established in the provided studies 2, 5, 6, 3, 4.