scholarly journals Type 2 Diabetes Mellitus: Cardiovascular Autonomic Neuropathy and Heart Rate Variability

2021 ◽  
Author(s):  
Sultana Ferdousi ◽  
Phurpa Gyeltshen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Parasympathetic Nervous System ◽  
Cardiovascular Autonomic Neuropathy

Type 2 Diabetes Mellitus is associated with both macro- and microvascular complications. One among the latter, is cardiovascular autonomic neuropathy (CAN). CAN is attributed to cardiac arrhythmias and sudden death. Underlying pathogenesis of cardiac autonomic neuropathy is chronic hyperglycemia induced oxidative stress causing neuronal necrosis, apoptosis and death, leading to the sympathetic and parasympathetic nerve dysfunction. The balance between sympathetic and parasympathetic nervous system is reflected by heart rate variability (HRV). HRV describes “the variations of both instantaneous heart rate and R-R intervals which in turn reflects the cardiac autonomic nervous control”. HRV measured at rest is a marker of autonomic nerve function status. Thus, HRV test is recommended to diagnose diabetic CAN. Time domain parameters predominantly reflect overall autonomic activity and parasympathetic nervous system (PNS) modulations. Frequency domain parameters either reflect, sympathetic nervous system (SNS) activity, PNS activity, or the balance between the two activities. Nonlinear HRV indices marks PNS influences, SNS influences and sympatho-vagal balance. Almost all these HRV parameters are remarkably reduced in T2DM due to cardiac autonomic dysfunction. HRV is an important simple and noninvasive diagnostic tool to detect CAN.

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 influence of type 2 diabetes mellitus on the frequency and complexity of ventricular arrhythmias and heart rate variability in patients after myocardial infarction

2016 ◽  
Vol 73 (11) ◽  
pp. 1050-1055
Author(s):  
Viktor Stoickov ◽  
Marina Deljanin-Ilic ◽  
Dijana Stojanovic ◽  
Stevan Ilic ◽  
Sandra Saric ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Ventricular Arrhythmias ◽  
Qt Dispersion ◽  
Rr Intervals

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.

scholarly journals Heart rate variability in type 2 diabetes mellitus: A systematic review and meta-analysis

2018 ◽  
Vol 79 (4) ◽  
pp. 465-466 ◽  
Author(s):  
T. Benichou ◽  
B. Pereira ◽  
M. Mermillod ◽  
P. Daniela ◽  
I. Tauveron ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 2 Diabetes Mellitus ◽  
Meta Analysis
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