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Cardiac autonomic dysfunction in type 2 diabetes - effect of hyperglycemia and disease duration.

Tarvainen MP, Laitinen TP, Lipponen JA, Cornforth DJ, Jelinek HF - Front Endocrinol (Lausanne) (2014)

Bottom Line: Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events.Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease.In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Physics, University of Eastern Finland , Kuopio , Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio , Finland.

ABSTRACT
Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients were analyzed. HRV was assessed using several time-domain, frequency-domain, and non-linear methods. HRV parameters showed a clear difference between healthy controls and T2DM patients. Hyperglycemia was associated with increase in mean heart rate and decrease in HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval and most of the HRV parameters. Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients. The most significant decrease in HRV related to diabetes and thus presence of autonomic neuropathy was observed within the first 5-10 years of disease progression.

No MeSH data available.


Related in: MedlinePlus

RR interval time series (bold line showing the removed trend) and AR spectrum estimates for healthy control subject (A), T2DM patient diagnosed 6 years prior to measurement (B), and T2DM patient diagnosed 13 years prior to measurement (C).
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Figure 1: RR interval time series (bold line showing the removed trend) and AR spectrum estimates for healthy control subject (A), T2DM patient diagnosed 6 years prior to measurement (B), and T2DM patient diagnosed 13 years prior to measurement (C).

Mentions: HRV analysis of the 20-min resting measurements was then performed as described in Section 2. RR interval data and power spectral estimates for three representative subjects are shown in Figure 1. The very low frequency trend components removed from the RR interval series prior to analysis are illustrated over the RR interval data. The mean RR interval length and the powers of the LF and HF components are highest for the healthy control (Figure 1A) and lowest for theT2DM patient with longer disease duration for similar age (Figure 1C).


Cardiac autonomic dysfunction in type 2 diabetes - effect of hyperglycemia and disease duration.

Tarvainen MP, Laitinen TP, Lipponen JA, Cornforth DJ, Jelinek HF - Front Endocrinol (Lausanne) (2014)

RR interval time series (bold line showing the removed trend) and AR spectrum estimates for healthy control subject (A), T2DM patient diagnosed 6 years prior to measurement (B), and T2DM patient diagnosed 13 years prior to measurement (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126058&req=5

Figure 1: RR interval time series (bold line showing the removed trend) and AR spectrum estimates for healthy control subject (A), T2DM patient diagnosed 6 years prior to measurement (B), and T2DM patient diagnosed 13 years prior to measurement (C).
Mentions: HRV analysis of the 20-min resting measurements was then performed as described in Section 2. RR interval data and power spectral estimates for three representative subjects are shown in Figure 1. The very low frequency trend components removed from the RR interval series prior to analysis are illustrated over the RR interval data. The mean RR interval length and the powers of the LF and HF components are highest for the healthy control (Figure 1A) and lowest for theT2DM patient with longer disease duration for similar age (Figure 1C).

Bottom Line: Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events.Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease.In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Applied Physics, University of Eastern Finland , Kuopio , Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio , Finland.

ABSTRACT
Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients were analyzed. HRV was assessed using several time-domain, frequency-domain, and non-linear methods. HRV parameters showed a clear difference between healthy controls and T2DM patients. Hyperglycemia was associated with increase in mean heart rate and decrease in HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval and most of the HRV parameters. Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5-10 years of the disease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients. The most significant decrease in HRV related to diabetes and thus presence of autonomic neuropathy was observed within the first 5-10 years of disease progression.

No MeSH data available.


Related in: MedlinePlus