scholarly journals Relationship between heart rate variability, low grade inflammation and glycated hemoglobin. A sugary sweet story

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Hadad ◽  
S F Akobe ◽  
P Weber ◽  
S B Haugaard ◽  
A Sajadieh
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Dysfunction ◽  
Microvascular Complications ◽  
Disease Process ◽  
Postprandial Hyperglycemia ◽  
Community Dwelling ◽  
Low Grade ◽  
Night Time ◽  
Low Grade Inflammation

Abstract Background Low grade inflammation (LGI) is significantly associated with microvascular complications in diabetes mellitus (DM). Reduced and impaired Heart rate variability (HRV) is a strong marker of autonomic dysfunction and neuropathy and strongly associated with microvascular disease in DM. New studies and observations indicate that the diabetic neuropathic process starts early during pre-diabetes. On the other hand, HRV and LGI are closely interrelated. Our aim was to evaluate whether LGI or hyperglycemia (i.e. high HbA1c) is associated with the autonomic dysfunction or reduced HRV among people with diabetes and pre-diabetes. Methods and materials This study is based on The Copenhagen Holter Study, in which 678 community dwelling subjects aged 55 – 75 years who were free of previous cardiovascular disease, except from well controlled hypertension, and who underwent a 48-hours Holter recording. Analysis of HRV including night-time HRV were available for 653 participants and this population included 133 people with well-controlled and newly recognized T2DM (mean HbA1c 55 mmol/mol (7.2%)) and 386 people with pre-diabetes defined as HbA1c between 39 mmol/mol (5.7%) and 47 mmol/mol (6.4%). We selected high-sensitive CRP, as markers of LGI. As measures of HRV we used the standard deviation of normal-to-normal (N-N) beats (SDNN), the root mean square of N-N beats (RMSSD) which has been acknowledged to be best linked to vagal parasympathetic tone, and the mean time between N-N complexes (meanNN) which represents the average 24-hour heart rate (60.000/meanNN = average 24-hour HR in beats/min) Results Measures of HRV were associated with HgbA1c among both people with T2DM and pre-diabetes. Among people with pre-diabetes HbA1c was inversely associated with 24-hour RMSSD (r=−0.11, p=0.03) and night-time SDNN (r=−0,13, p>0.01), while among T2DM HgbA1c was only associated with 24-hour RMSSD (r=−0.21, p=0.02). These association stayed significant when adjusted for sex, age, BMI, smoking, HOMA-ir, hs-CRP and systolic blood pressure in multiple linear regression (Table 1). LGI was only associated with HRV in diabetes. HbA1c was not associated with any measures of HRV or LGI among people with normal glucose metabolism. Conclusion HRV is closely and inversely associated with HbA1c in both diabetes and prediabetes, but only in diabetes LGI is associated with HRV. This indicates that the process of autonomic dysfunction/neuropathy starts at an early phase during pre-diabetes and probably provoked by postprandial hyperglycemia, while in diabetes both HbA1c and LGI are associated with HRV showing that LGI is activated later in the disease process probably provoked by long-term postprandial hyperglycemia, indicating treatment of hyperglycemia and postprandial hyperglycemia in the prediabetes state may be helpful. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Night heart rate variability identifies cardiovascular risk in community dwelling people with uncomplicated type 2 diabetes mellitus

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Hadad ◽  
B.S Larsen ◽  
A.S Fenger ◽  
D Stavnem ◽  
N Mattsson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
Community Dwelling ◽  
Funding Source ◽  
Night Time ◽  
Increased Risk

Abstract Introduction Low Heart rate variability (HRV) reflects cardiac autonomic neuropathy, associated with increased cardiovascular mortality in type 2 diabetes (T2DM) patients. Measuring HRV is challenged by environmental noise, mental stress and physical activity during the day-time. Thus, measuring night-time HRV during sleep may be a better tool to predict cardiovascular (CV) events in low risk T2DM patients without previous cardiovascular disease. Methods Copenhagen Holter Study included 678 community dwelling subjects aged 55–75 years free of previous cardiovascular disease. Day- and night-time HRV were available for 653. The population included 133 well-controlled T2DM patients (mean HbA1c 7.2%). Median follow- up was 14.4 years. HRV is defined as standard deviation for the mean value of normal-to-normal complexes (SDNN). Night-time HRV measurements were pre-defined from 2:00 to 2:15 AM. CV events were defined as CV death, myocardial infarction, stroke, or coronary revascularization. Results The rate of CV events was 17 and 31 per 1000 patient-year in patients without and with T2DM, respectively (p=0.015). Night-time SDNN was inversely associated with CV events in T2DM patients with a HR of 0.74 (0.61–0.89), P=0.001, for each 10 ms increment in SDNN, after adjustment for sex, age, LDL, smoking, systolic BP, glucose, CRP and NT pro-BNP (table 1). Twenty-four-hours HRV was not associated with cardiovascular events (table 1). Conventional risk factors had an AUC of 0.704 (95% CI 0.602–0.806) to predict CV events in T2DM. Prediction was improved by the addition of night-time SDNN; AUC 0.765 (95% CI 0.669–0.862), P=0.037, but not by CRP or NT-proBNP (Figure 1). In subjects with well-controlled T2DM and night-time SDNN ≤30 ms, the 10-year risk of CV death and CV even-rate were 12% and 45%, respectively. This allocates these T2DM patients in a “very high-risk” group, and more aggressive targets for blood-pressure and lipids according to the current guidelines. Conclusion Reduced night-time HRV associates with increased risk of CV events in persons with well-controlled T2DM. We observed improved risk prediction of cardiovascular events in T2DM by night-time HRV, which may have therapeutic consequences. Figure 1. ROC Curve Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Danish Heart Foundation

scholarly journals Heart rate variability changes in mild-symptomatic, physically fit male in 4-6 weeks from the end of SARS-Cov-2 infection

2021 ◽  
Author(s):  
Mateusz Soliński ◽  
Agnieszka Pawlak ◽  
Monika Petelczyc ◽  
Teodor Buchner ◽  
Joanna Aftyka ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Respiratory Rhythm ◽  
Frequency Component ◽  
Night Time ◽  
Control Male ◽  
Autonomic Nervous ◽  
Male Subjects

Abstract SARS-Cov-2 infection, due to inflammation processes, can affect autonomic nervous system and heart rate variability (HRV) even after disease. Previous studies showed significant changes in HRV parameters in severe (including fatal) infection of SARS-Cov-2. However, HRV analysis for the asymptomatic or mild-symptomatic Covid-19 patients have not been reported. In this study, we suggested that there is an influence of a SARS-Cov-2 infection on the HRV in such patients after weeks form disease.Sixty-five ECG Holter recordings from young (mean age 22.6 ± 3.4 years), physically fit male subjects after 4-6 weeks from the second negative test (considered to be the beginning of recovery) and twenty-six control male subjects (mean age 23.2 ± 2.9 years) were considered in the study. Night-time RR time series were extracted from ECG signals. Selected linear, frequency as well as nonlinear HRV parameters were calculated. We found significant differences in Porta’s symbolic analysis parameters V0 and V2 (p<0.001), α2 (p<0.001), very low frequency component (VLF; p=0.022), and respiratory peak (from PRSA method; p=0.012). These differences may be caused by the changes of the parasympathetic autonomic nervous system as well as by the coupling of respiratory rhythm with heart rate due to an increase in pulmonary arterial vascular resistance.The results suggest that the changes in the HRV, thus autonomic nervous system, are measurable after a few weeks from the beginning of the recovery even in the post-Covid group of young and physically active population. We indicated HRV sensitive markers which could be used in the long-term monitoring of recovered patients.

Abstract TP209: Decreased Heart Rate Variability in Patients With Minor Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sungwook Yu ◽  
YooHwan Kim ◽  
Kyung-Hee Cho ◽  
Byung-Jo Kim
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Autonomic Dysfunction ◽  
Minor Stroke ◽  
Axon Reflex ◽  
Nihss Score ◽  
Minor Ischemic Stroke ◽  
Major Stroke

Introduction: Minor stroke or transient ischemic attack (TIA) is considered to have little effect on autonomic functions. However, it is unclear whether autonomic dysfunction in patients with minor stroke develops during acute stroke phase. Hypothesis: We evaluated whether patients with minor stroke had autonomic dysfunction during acute stroke phase. Methods: Patients with ischemic stroke or TIA were included. Those with diabetes and urological problems were excluded. Quantitative sudomotor axon reflex test (QSART), head-up tilt test (HUTT), sympathetic skin response (SSR), and heart rate variability (HRV) were performed during admission after acute stroke onset. HRV frequency measurements included time-domain and frequency-domain parameters. We analyzed the difference of autonomic function among patients with minor stroke (NIHSS score ≤ 3), major stroke (NIHSS score≥3) and TIA. Results: Total of 81 patients was included. There were 55 with minor ischemic stroke, 15 with major ischemic stroke, and 11 with TIA. RR interval of HRV was significantly different among three groups (938.8 ± 99.1 ms in TIA, 871.4 ± 104.9 ms in minor stroke, and 832.7 ± 107.8 ms in major stroke, P = 0.042). Parameters of HRV in patients with stroke had significantly lower compared to those with TIA [high frequency (HF) 8.9 ± 3.6 ms2 vs 12.2 ± 5.0 ms2, respectively, P = 0.013; the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), 23.5 ± 9.3 ms vs 30.7 ± 11.6 ms, respectively, P = 0.023]. Moreover, HF and RMSSD significantly decreased in patients with minor stroke compared to those with TIA (HF, 8.9 ± 3.6 ms2 vs 12.2 ± 5.0 ms2, respectively, P = 0.038; RMSSD, 23.2 ± 9.4 ms vs 30.7 ± 11.6 ms, respectively, P = 0.05). Results of QSART, HUTT and SSR were not different among three groups. Conclusion: Patients with minor stroke had decreased HRV compared to those with TIA, indicating that even minor stroke could be associated with decreased parasympathetic activity at early stroke phase. Further studies will be needed to evaluate effects of autonomic dysfunction on clinical outcome in patients with minor stroke.

scholarly journals Heart Rate Variability for Quantification of Autonomic Dysfunction in Fibromyalgia

2016 ◽  
Vol 40 (2) ◽  
pp. 301 ◽  
Author(s):  
Jin Ho Kang ◽  
Jong Kyu Kim ◽  
Seok Hyun Hong ◽  
Chang Hyun Lee ◽  
Byoong Yong Choi
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Dysfunction

scholarly journals Changes in Heart Rate Variability and Glycosylated Hemoglobin in Prediabetics and Type 2 Diabetes Mellitus

2017 ◽  
Vol 5 (1) ◽  
pp. 15-18
Author(s):  
A.K. Mishra ◽  
R.K. Jha ◽  
B.K. Kapoor
Keyword(s):  
Diabetes Mellitus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Time Domain ◽  
Glycosylated Hemoglobin ◽  
Disease Process ◽  
Significant Rise ◽  
Parasympathetic Activity ◽  
Cardiac Autonomic Neuropathy

Background People with diabetes mellitus (DM) suffer from cardiac autonomic neuropathy (CAN), this may remain subclinical and reduced heart rate variability (HRV) is noticed as its early indicator.Objective The present study was undertaken to investigate the changes in heart rate variability and glycosylated hemoglobin (HbA1C) in (i) pre-diabetics, (ii) diabetics, (iii) non-diabetic subjects.Methods The present study enrolled 30 patients, diagnosed with type 2 DM and 30 prediabetic subjects aged between 30-60 years and compared with its aged matched healthy controls. In HRV, Time Domain (TD) parameters used were: SDNN, rMSSD, NN50 and pNN50%; and Frequency Domain (FD) parameters were: low frequency (LF), high frequency (HF) and LF/HF ratio. Glycosylated Hb and random blood sugar were measured.Results In HRV, though the time domain measures that reflects parasympathetic activity decreased was insignificant in the cases, the FD parameters such as LF reflecting activities of both division of ANS and HF reflecting only parasympathetic activity were found significantly reduced in diabetes and then control, whereas LF/HF ratio was increased only in diabetic patient (p<0.001) indicating sympathovagal imbalance. Rise in HbA1C was insignificant in prediabetic compared to control, which was observed significant only in diabetic (p< 0.001) patients.Conclusion Findings of the present study suggest that though HbA1c is an indicator of sustained hyperglycemia for monitoring glycemic level, even before its significant rise in plasma, alteration of sympatho-vagal balance over heart begins early in the disease process of diabetes.Journal of Advances in Internal Medicine 2016;05(01):15-18

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