scholarly journals Cardiac Autonomic Neuropathy Measured by Heart Rate Variability and Markers of Subclinical Atherosclerosis in Early Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Hossein Fakhrzadeh ◽  
Ahmad Yamini-Sharif ◽  
Farshad Sharifi ◽  
Yaser Tajalizadekhoob ◽  
Mojde Mirarefin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Subclinical Atherosclerosis ◽  
Total Power ◽  
Cardiac Autonomic Neuropathy ◽  
Inverse Association

Cardiac autonomic neuropathy (CAN) is a critical complication of type 2 diabetes mellitus (T2DM). Heart rate variability (HRV) is a noninvasive tool to assess cardiac autonomic function. We aimed to evaluate whether CAN is associated with increased risk of atherosclerosis in T2DM. A total of 57 diabetic and 54 nondiabetic subjects, free of coronary heart disease, were recruited. Carotid intima media thickness (CIMT), coronary calcium score (CAC), and brachial Flow Mediated Dilation (FMD) were measured. Heart rate variability and vagal components of autonomic function were determined. Significant reduction of normalized HF power (P<0.05) and total power (P<0.01) was observed in T2DM. CIMT and CAC scores were significantly higher while FMD was significantly lower in diabetics (P<0.01 for all). Median HbA1c levels were significantly higher in diabetics. CIMT was inversely and independently associated with total power both in diabetics and controls (P<0.01 for both groups). There was also an inverse association between total power and median HbA1c. Autonomic dysfunction, especially parasympathetic neuropathy, was present since early-stage T2DM. This was related to subclinical atherosclerosis. Early detection of cardiac autonomic neuropathy can help us detect the development of atherosclerosis earlier in T2DM to prevent unfavorable outcomes.

scholarly journals Heart rate variability evaluation in the assessment of cardiac autonomic neuropathy in patients with type 2 diabetes

Cor et Vasa ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. e335-e344 ◽  
Author(s):  
Rudolf Metelka ◽  
Lubica Cibičková ◽  
Jaromíra Gajdová ◽  
Ondřej Krystyník
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy

Heart Rate Variability and Heart Rate Turbulence in Patients With Type 2 Diabetes Mellitus With Versus Without Cardiac Autonomic Neuropathy

2007 ◽  
Vol 100 (5) ◽  
pp. 890-893 ◽  
Author(s):  
Serhat Balcıoğlu ◽  
Uğur Arslan ◽  
Sedat Türkoğlu ◽  
Murat Özdemir ◽  
Atiye Çengel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Heart Rate Turbulence

scholarly journals Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea

2017 ◽  
Vol 41 (4) ◽  
pp. 275 ◽  
Author(s):  
Sol Jae Lee ◽  
Su Jin Jeong ◽  
Yu Chang Lee ◽  
Yong Hoon Lee ◽  
Jung Eun Lee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Lipoic Acid ◽  
Cardiac Autonomic Neuropathy ◽  
High Dose

scholarly journals EVALUATION OF AUTONOMIC DYSFUNCTION BY HEART RATE VARIABILITY ANALYSIS IN TYPE 2 DIABETES MELLITUS

2016 ◽  
Vol 10 (1) ◽  
pp. 309
Author(s):  
Phurpa Nil Nil ◽  
Sultana - Ferdousi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Autonomic Dysfunction ◽  
Cardiac Autonomic Neuropathy ◽  
Heart Rate Variability Analysis

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.

scholarly journals Cardiac Autonomic Neuropathy in Diabetes Mellitus Patients – Are We Aware of the Consequences?

2020 ◽  
Vol 66 (1) ◽  
pp. 3-8
Author(s):  
Anca Motataianu ◽  
Laura Iulia Barcutean ◽  
Smaranda Maier ◽  
Adrian Balasa ◽  
Adina Stoian
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Long Term Effects

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.

scholarly journals The Association Between Continuous Glucose Monitoring-derived Metrics, Including Time in Range, and Cardiovascular Autonomic Neuropathy in Outpatients With Type 2 Diabetes

2020 ◽  
Author(s):  
Min Young Kim ◽  
Gyuri Kim ◽  
Ji Yun Park ◽  
Min Sun Choi ◽  
Ji Eun Jun ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Cardiovascular Autonomic Neuropathy ◽  
Inverse Association ◽  
International Consensus ◽  
Time In Range

Abstract BackgroundContinuous glucose monitoring (CGM)-derived metrics including time in range (TIR) are attracting attention as new indicators of glycemic control and diabetes complications beyond hemoglobin A1c. This study investigated the association between CGM-derived TIR, hyperglycemia, hypoglycemia metrics, and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes.MethodsA total of 284 patients with type 2 diabetes who underwent CGM for three days and autonomic function tests within three months based on outpatient data were recruited. The definition of CGM-derived metrics was subject to the most recent international consensus. CAN was defined as an abnormal case in two or more parasympathetic and the severity of CAN was estimated as the sum of the scores of the five cardiovascular autonomic function tests.ResultsMultiple logistic regression analysis revealed that the odds ratio of definite CAN was 0.876 [95% confidence interval (CI): 0.79–0.98] per 10% increase in the TIR of 70 to 180 mg/dL, after adjusting for age, sex, diabetes duration, any medications, and glycemic variability. A 10% increase in TIR was significantly inversely associated with the presence of advanced CAN (OR: 0.89, 95% CI: 0.81–0.98). In addition, there was a strong inverse association between a 10% increase in the TIR and the total CAN score (p for trend = 0.001). Among the metrics of hyperglycemia, a time above range (TAR) of greater than 180 mg/dL was also independently correlated with the presence of definite CAN (OR: 1.013, 95% CI: 1.00–1.02) and advanced CAN (OR: 1.01, 95% CI: 1.00–1.02).ConclusionsA TIR value of 70 to 180 mg/dL and a TAR value of greater than 180 mg/dL were significantly associated with cardiovascular autonomic neuropathy in outpatients with type 2 diabetes.

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