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Diabetes mellitus can cause cardiovascular autonomic neuropathy and is associated with increased cardiovascular deaths. We investigated cardiovascular autonomic neuropathy in diabetics and healthy controls by analysis of heart rate variability. Thirty-one diabetics and 30 age-and sexmatched controls were included. In the time domain we measured the mean R -R interval (NN), the standard deviation of the R -R interval index (SDNN), the standard deviation of the 5-min R -R interval mean (SDANN), the root mean square of successive R -R interval differences (RMSSD) and the percentage of beats with a consecutive R -R interval difference > 50 ms (pNN50). In the frequency domain we measured high-frequency power (HF), low-frequency power (LF) and the LF/HF ratio. Diabetes patients had lower values for time-domain and frequency-domain parameters than controls. Most heart rate variability parameters were lower in diabetes patients with chronic complications than in those without chronic complications.

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It was concluded that deltaP increased in patients with PAF and normal LA size. In controls with increased LA size, deltaP increased but did not reach the levels attained in patients with PAF. The AEF was decreased in patients with PAF but was preserved in those without PAF. These findings can be explained by the changes in LA microarchitecture which concurrently decreased atrial myocardial contraction, increased deltaP, and predisposed to PAF.

Extra-coronary atherosclerosis and vascular calcification are associated with LVH in HD patients. Whether the treatment of atherosclerosis or vascular calcification may cause regression of or even prevent LVH in HD patients remains to be seen.

The recovery of HRV regardless to the preoperative state of the patients and their postoperative course implies that the early drop of HRV after CABG was related to the acute effects of surgery. Late complete recovery of HRV may be due to resolution of ischemia or use of angiotensin-converting enzyme inhibitor.

The presence of AF was significantly related to the prolongation of PWd, but not with pulmonary function, arterial blood gasses, and left and right atrial function.

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