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In nine patients, selected heartrate variability (HRV) parameters were lower than guide values. Cardiomyopathy, typical of MD, had not been found in patients with MPAN. There were no significant arrhythmias, but disruptions when you look at the circadian rhythm of this heartbeat had been observed in many cases. The decline in HRV may mirror an early indication of autonomic dysfunction. A standard cardiac work-up is recommended for customers with MPAN to assess if additional