Normative reference of short-term heart rate variability and estimation of cardiovascular autonomic neuropathy prevalence in Chinese people

2014 ◽  
Vol 37 (4) ◽  
pp. 385-391 ◽  
Author(s):  
F. Zeng ◽  
Z.-H. Tang ◽  
Z. Li ◽  
X. Yu ◽  
L. Zhou
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy ◽  
Chinese People ◽  
Short Term

scholarly journals Bayesian estimation of cardiovascular autonomic neuropathy diagnostic test based on short-term heart rate variability without a gold standard

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005096 ◽  
Author(s):  
Zi-Hui Tang ◽  
Lin Wang ◽  
Fangfang Zeng ◽  
Zhongtao Li ◽  
Xiaoling Yu ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Diagnostic Test ◽  
Autonomic Neuropathy ◽  
Reference Values ◽  
Gold Standard ◽  
High Sensitivity ◽  
Cardiovascular Autonomic Neuropathy ◽  
Total Power ◽  
Short Term

ObjectiveTo evaluate the reference values for short-term heart rate variability (HRV), estimate the performance of cardiovascular autonomic neuropathy (CAN) diagnostic tests in the absence of a gold standard, and assess CAN prevalence in our dataset.SettingCommunity and hospital health centre.ParticipantsOf 2092 subjects available for data analysis, 371 healthy subjects were selected so the reference values for the short-term HRV test could be evaluated. An external dataset contained 88 subjects who completed both the short-term HRV test and Ewing's test.InterventionCollection of information on clinical outcome.Primary and second outcome measuresCardiovascular autonomic function evaluated by using the short-term HRV test and/or Ewing's test.ResultsCut-off points of 356.13, 55.45 and 36.64 ms2 were set for total power, low frequency and high frequency (HF), respectively. The diagnostic test for CAN based on the mentioned reference value was created. The HRV test had a high sensitivity (80.01–85.09%) and specificity (82.30–85.20%) for CAN. In addition, the non-inferiority test rejected the null hypothesis that the performance of the HRV test was inferior to that of Ewing's test (p<0.05). The estimated CAN prevalence was 14.92% and 29.17% in the total sample and patients with diabetes, respectively.ConclusionsOur findings provided reference values for short-term HRV, which were used for the CAN diagnostic test with high sensitivity and specificity. The estimated CAN prevalence was high in the Chinese population.

scholarly journals Circulating Inflammatory Markers Are Inversely Associated with Heart Rate Variability Measures in Type 1 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Anne-Marie L. Wegeberg ◽  
Tina Okdahl ◽  
Tina Fløyel ◽  
Christina Brock ◽  
Niels Ejskjaer ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 1 Diabetes ◽  
Adhesion Molecules ◽  
Autonomic Neuropathy ◽  
Vagal Tone ◽  
Cardiovascular Autonomic Neuropathy ◽  
Intercellular Adhesion Molecule ◽  
Cardiac Vagal Tone

Introduction. A neuroimmune communication exists, and compelling evidence suggests that diabetic neuropathy and systemic inflammation are linked. Our aims were (1) to investigate biomarkers of the ongoing inflammation processes including cytokines, adhesion molecules, and chemokines and (2) to associate the findings with cardiovascular autonomic neuropathy in type 1 diabetes by measuring heart rate variability and cardiac vagal tone. Materials and Methods. We included 104 adults with type 1 diabetes. Heart rate variability, time domain, and frequency domains were calculated from a 24-hour Holter electrocardiogram, while cardiac vagal tone was determined from a 5-minute electrocardiogram. Cytokines (interleukin- (IL-) 1α, IL-4, IL-12p70, IL-13, IL-17, and tumor necrosis factor- (TNF-) α), adhesion molecules (E-selectin, P-selectin, and intercellular adhesion molecule- (ICAM-) 1), and chemokines (chemokine (C-C motif) ligand (CCL)2, CCL3, CCL4, and C-X-C motif chemokine (CXCL)10) were assessed using a Luminex multiplexing technology. Associations between concentrations of inflammatory biomarkers and continuous variables of heart rate variability and cardiac vagal tone were estimated using multivariable linear regression adjusting for age, sex, disease duration, and smoking. Results. Participants with the presence of cardiovascular autonomic neuropathy had higher systemic levels of IL-1α, IL-4, CCL2, and E-selectin than those without cardiovascular autonomic neuropathy. IL-1α, IL-4, IL-12, TNF-α, and E-selectin were inversely associated with both sympathetic and parasympathetic heart rate variability measures (p>0.01). Discussion. Our results show that several pro- and anti-inflammatory factors, believed to be involved in the progression of diabetic polyneuropathy, are associated with cardiovascular autonomic neuropathy, suggesting that these factors may also contribute to the pathogenesis of cardiovascular autonomic neuropathy. Our findings emphasize the importance of the neuroimmune regulatory system in the pathogenesis of neuropathy in type 1 diabetes.

Heart Rate Variability in Diabetes Patients

2006 ◽  
Vol 34 (3) ◽  
pp. 291-296 ◽  
Author(s):  
H Kudat ◽  
V Akkaya ◽  
AB Sozen ◽  
S Salman ◽  
S Demirel ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Frequency Domain ◽  
Autonomic Neuropathy ◽  
Time Domain ◽  
Cardiovascular Autonomic Neuropathy ◽  
Chronic Complications ◽  
Frequency Power ◽  
Diabetes Patients

Diabetes mellitus can cause cardiovascular autonomic neuropathy and is associated with increased cardiovascular deaths. We investigated cardiovascular autonomic neuropathy in diabetics and healthy controls by analysis of heart rate variability. Thirty-one diabetics and 30 age- and sex-matched controls were included. In the time domain we measured the mean R-R interval (NN), the standard deviation of the R-R interval index (SDNN), the standard deviation of the 5-min R - R interval mean (SDANN), the root mean square of successive R - R interval differences (RMSSD) and the percentage of beats with a consecutive R - R interval difference > 50 ms (pNN50). In the frequency domain we measured high-frequency power (HF), low-frequency power (LF) and the LF/HF ratio. Diabetes patients had lower values for time-domain and frequency-domain parameters than controls. Most heart rate variability parameters were lower in diabetes patients with chronic complications than in those without chronic complications.

Cardiovascular Autonomic Reflex Tests and 7 Heart Rate Variability Indices for Early Diagnosis of Cardiovascular Autonomic Neuropathy in Type 2 Diabetes Individuals

2021 ◽  
Vol 17 ◽  
Author(s):  
Yeelen Ballesteros Atala ◽  
Mozânia Reis De Matos ◽  
Denise Engelbrecht Zantut-Wittmann ◽  
Alejandro Rosell Castillo ◽  
Daniele P Santos-Bezerra ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Valsalva Maneuver ◽  
Cross Sectional Study ◽  
Cardiovascular Autonomic Neuropathy ◽  
Cross Sectional ◽  
Autonomic Reflex

Background: Cardiovascular autonomic neuropathy (CAN) is a common complication of type 2 Diabetes mellitus (T2D), and prevalence varies according to the methodology used. CAN should be diagnosed in the subclinical stage when an intensive treatment of T2D could avoid the progression to irreversible phases. Objective: Determine the prevalence of early involvement (EI) of CAN in T2D individuals comparing two methodologies. Methods: This was a cross-sectional study that included 183 T2D individuals who were monitored in a Tertiary centre. The diagnosis of CAN was based on the results of four cardiovascular autonomic reflex tests (CARTs: expiration-inspiration index, Valsalva maneuver, orthostatic test, and changes in blood pressure after standing) and of seven heart rate variability (7HRV) indices (CARTs plus the spectral analysis). The findings were validated in an independent cohort comprised of 562 T2D individuals followed in a Primary care setting. Results: With the use of 7HRV, 30.6% and 77.8% of individuals in the Tertiary and in the Primary centers, respectively, were classified as without CAN; 25.1% and 15.3% as EI and 44.3% and 6.9% as definitive CAN, respectively. The use of CARTs decreased the proportion of individuals without CAN in both centers (7.1% and 47%) and increased the frequency of EI (30.6% and 36.6%) and definitive CAN (62.3% and 16.4%), respectively. The concordance between both evaluated methodologies was weak. Conclusion: Higher proportions of T2D individuals were diagnosed with EI and with definitive CAN with the use of CARTs.

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