Stratification of the Type 2 Diabetes Mellitus Based on Heart Rate Variability Parameters in Elderly Women at Rest

2020 ◽  
Vol 7 (3) ◽  
pp. 01-08
Author(s):  
Wollner Materko ◽  
Daianne Freires Fernandes ◽  
Francineide Pereira da Silva Pena

Cardiac autonomic neuropathy in type 2 diabetes mellitus (T2DM) patients is frequent and associated with high cardiovascular mortality. The purpose of the present study was to stratify the T2DM using a logistic model based on parameters derived from heart rate variability (HRV). This study was designed as a cross-sectional study of consisted of thirty elderly women subjects 60 to 70 yrs of age with diagnosed with T2DM (N = 15) and healthy (N = 15). All subjects were instructed to lie in the supine position for 5 min at rest while breathing normally with a heart rate monitor Polar RS810 working at a sampling rate of 1000 Hz was used to record RR intervals (RRi). The HRV analysis in the time domain was performed to obtain the classical parameters pNN50, SDNN, RMSSD and MeanRRi and, subsequently, re-sampling procedure to bootstrapping based on 1000 samples. The model for predicting T2DM was obtained by backward stepwise multivariate logistic regression assuming as independent variable MeanRRi. This model presented 0.80 positive predictive value, 0.73 negative predictive value and 0.76 total accuracy. In conclusion, the use of the proposed MeanRRi parameter measured at rest seems to be able to stratify the T2DM in elderly women. The benefits of HRV monitoring the severity of T2DM should be potential as a reliable and non-invasive.

Author(s):  
Phurpa Nil Nil ◽  
Sultana - Ferdousi

ABSTRACTObjective: Cardiac autonomic neuropathy (CAN) is a severe and common, yet highly underdiagnosed, complication of Type 2 diabetes mellitus(T2DM). Subclinical CAN may have reduced heart rate variability (HRV) but normal Ewing battery test. This study was performed to evaluate theimportance of 5 minutes HRV for the detection of autonomic dysfunction in T2DM without (CAN-T2DM).Methods: This cross-sectional observational study was conducted at the Department of Physiology, Bangabandhu Sheikh Mujib Medical University(BSMMU) on 30 recently diagnosed T2DM (RT2DM) and 54 long-term CAN-male T2DM patients (LT2DM), aged 45-55 years, from the EndocrinologyOut Patient Department of BSMMU, Dhaka. 30 age and body mass index matched apparently healthy male subjects were control. Ewing battery testwas used to rule out CAN positive T2DM. HRV data were recorded by a polyrite-D and analyzed by software. HRV was assessed by time domainmethod. For statistical analysis, ANOVA and unpaired t-test were used.Results: Mean RR, standard deviation of NN intervals (SDNN) (p<0.05), and root mean square of the successive differences (RMSSD) were significantly(p<0.001) lower, and mean HR and SDNN/RMSSD were (p<0.001) significantly higher in LT2DM compared to RT2DM and control. In addition, SDNNwas also significantly (p<0.05) lower in RT2DM than that of control.Conclusions: Results conclude that autonomic dysfunction may occur in both LT2DM and RT2DM patients without neuropathy and 5 minutes HRVtest is an important tool for detecting subclinical CAN.Keywords: Type 2 diabetes mellitus, Cardiac autonomic neuropathy, Heart rate variability.


2020 ◽  
Vol 66 (1) ◽  
pp. 3-8
Author(s):  
Anca Motataianu ◽  
Laura Iulia Barcutean ◽  
Smaranda Maier ◽  
Adrian Balasa ◽  
Adina Stoian

AbstractCardiovascular autonomic neuropathy is the most frequent clinical form of autonomous diabetic neuropathy and appears secondary to cardiac autonomous fibre involvement, actively involved in cardiac rhythm impairment. Type 2 diabetes mellitus patients can present cardiac autonomic neuropathy early in the disease. Autonomous nerve function in DM patients should be assessed as early as the diagnosis is set in order to establish the optimal therapeutic strategy. The most frequent cardio-vagal test used is heart rate variability. An abnormal heart rate variability in the presence of orthostatic arterial hypotension indicates a severe cardiac autonomic neuropathy diagnosis. The development of cardiac autonomic neuropathy is subjected to glycaemic control, duration of the disease and associated risk factors. The glycaemic control is extremely important, especially early in the disease. Therefore, a poor glycaemic control carries unfavourable long-term effects, despite an ulterior optimal control, a phenomenon named “hyperglycaemic memory”. In type 2 diabetes mellitus patients, the association of cardiac autonomic neuropathy with intensive glycaemic control increases the mortality rate, due to the fact, that, secondary to autonomous impairment, the patients do not present the typical symptoms associated with hypoglycaemia. Stratifying the cardiac autonomic neuropathy aids the clinician in assessing the morbidity and mortality risk of diabetes mellitus patients, because it is an independent risk factor for mortality, associated with silent myocardial infarctions and the risk of sudden death.


2016 ◽  
Vol 73 (11) ◽  
pp. 1050-1055
Author(s):  
Viktor Stoickov ◽  
Marina Deljanin-Ilic ◽  
Dijana Stojanovic ◽  
Stevan Ilic ◽  
Sandra Saric ◽  
...  

Background/Aim. After myocardial infarction arrhythmic cardiac deaths are significantly more frequent compared to non-arrhythmic ones. The aim of the study was to investigate the influence of type 2 diabetes mellitus (T2DM) on the frequency and complexity of ventricular arrhythmias after myocardial infarction. Methods. The study included 293 patients, mean age 59.5 ? 9.21 years, who were at least six months after acute myocardial infarction with the sinus rhythm, without atrioventricular blocks and branch blocks. In the clinical group 95 (32.42%) patients were with T2DM, while 198 (67.57%) patients were without diabetes. All of the patients were subjected to the following procedures: standard ECG according to which the corrected QT dispersion (QTdc) was calculated, exercise stress test, and 24-hour holter monitoring according to which, the four parameters of time domain of heart rate variability (HRV) were analyzed: standard deviation of all normal RR intervals during 24 hours (SDNN), standard deviation of the averages of normal RR intervals in all five-minute segments during 24 hours (SDANN), the square root of the mean of the sum of the squares of differences between adjacent normal (RMS-SD), and percentage of consequtive RR intervals which differed for more than 50 ms during 24 hours (NN > 50 ms). Results. In patients after myocardial infarction, patients with T2DM had significantly higher percentage of frequent and complex ventricular arrhythmias compared to the patients without diabetes (p < 0.001). The patients with T2DM had significantly higher percentage of residual ischemia (p < 0.001), and arterial hypertension (p < 0.001), compared to patients without diabetes. The patients with T2DM had significantly lower values of HRV parameters: SDNN (p < 0.001); SDANN (p < 0.001); RMS-SD (p < 0.001), and NN > 50 ms (p < 0.001), and significantly higher values of QTdc (p < 0.001) compared to the patients without diabetes. Conclusion. The study showed that type 2 diabetes mellitus has significant influence on ventricular arrhythmias, HRV parameters and QT dispersion in patients after myocardial infarction.


2018 ◽  
Vol 79 (4) ◽  
pp. 465-466 ◽  
Author(s):  
T. Benichou ◽  
B. Pereira ◽  
M. Mermillod ◽  
P. Daniela ◽  
I. Tauveron ◽  
...  

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