Sensitivity, Specificity and Predictive Value of Heart Rate Variability Indices in Type 1 Diabetes Mellitus

Abstract

BackgroundHeart rate variability (HRV) indices may detect autonomic changes with good diagnostic accuracy. Type diabetes mellitus (DM) individuals may have changes in autonomic modulation; however, studies of this nature in this population are still scarce.ObjectiveTo compare HRV indices between and assess their prognostic value by measurements of sensitivity, specificity and predictive values in young individuals with type 1 DM and healthy volunteers.MethodsIn this cross-sectional study, physical and clinical assessment was performed in 39 young patients with type 1 DM and 43 young healthy controls. For HRV analysis, beat-to-beat heart rate variability was measured in dorsal decubitus, using a Polar S810i heart rate monitor, for 30 minutes. The following indices were calculated: SDNN, RMSSD, PNN50, TINN, RRTri, LF ms2, HF ms2, LF un, HF un, LF/HF, SD1, SD2, SD1/SD2, and ApEn.ResultsType 1 DM subjects showed a decrease in sympathetic and parasympathetic activities, and overall variability of autonomic nervous system. The RMSSD, SDNN, PNN50, LF ms2, HF ms2, RRTri, SD1 and SD2 indices showed greater diagnostic accuracy in discriminating diabetic from healthy individuals.ConclusionType 1 DM individuals have changes in autonomic modulation. The SDNN, RMSSD, PNN50, RRtri, LF ms2, HF ms2, SD1 and SD2 indices may be alternative tools to discriminate individuals with type 1 DM.

Analysis of a Pulse Rate Variability Measurement Using a Smartphone Camera

“…It is anticipated that new methods will aid studies involving large populations, which hopefully will allow us to expand our physiological knowledge and improve our understanding of its clinical relevance [2]. Previously published articles presented new methods and analytical techniques on this topic [4–8]. However, a breakthrough has not been achieved since we have so far failed to collect a critical amount of data from either healthy or sick populations [2].…”

Cardiac Autonomic Functions May Be Influenced by Body Weight

“…Recently, a research reported decreased HRV because of inflammatory processes in the obese population 4 . In the study by Silva et al, 1 it is clearly seen that there is a statistically significant difference between the healthy group and the diabetic group in terms of body mass index. In addition, the blood lipid levels of the study population are not available in the study by Silva et al 1 .…”

“…It was showed a decrease in sympathetic and parasympathetic activities, as well as overall variability of autonomic nervous system in the diabetic group. I would like to congratulate Silva et al 1 for their valuable effort in this study. I also have a few comments to do.…”

“…I read the paper by Silva et al 1 entitled ‘‘Sensitivity, Specificity and Predictive Value of Heart Rate Variability Indices in Type 1 Diabetes Mellitus’’ published in Arquivos Brasileiros de Cardiologia in March 2017. They aimed to compare Heart Rate Variability (HRV) indices and evaluate their sensitivity, specificity, and predictive value in young type 1 diabetic patients and healthy volunteers.…”

“…The indices of HRV give us valuable numeric data about cardiac autonomic nerve system by processing RR interval variability beat-to-beat. A decrease in HRV implying an impaired autonomic cardiac function is one of the independent risk factors related to sudden cardiac death 1 - 4 . Several variables such as age, sex, obesity, drugs, ischemic heart disease, hypertension, hyperlipidemia, insulin resistance, might have effect on HRV indices 1 - 4 .…”