Predictors and diagnosis of cardiac autonomic nervous dysfunction in patients with type 1 and type 2 diabetes mellitus

Popov, K; Андреевич, Попов Кирилл; Tokmakova, Alla Yur'evna; Юрьевна, Токмакова Алла; Бондаренко, И. З.; Зиятовна, Бондаренко Ирина

doi:10.14341/8156

Cited by 4 publications

(2 citation statements)

References 61 publications

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“…При этом более 70% эпизодов ночных гипогликемий носят бессимптомный характер [10] и чаще обнаруживаются у больных с КАН [11,12]. Вместе с этим и ночные гипогликемии, и КАН ассоциированы с удлинением интервала QTc [13,14]. Независимая роль этих факторов как предикторов удлинения интервала QTc остается неизученной, что ограничивает наше понимание патофизиологических механизмов удлинения QTc и препятствует разработке более эффективных методов лечения.…”

Section: обоснованиеunclassified

“…Механизм удлинения QTc при КАН связан с гиперсимпатикотонией (вагусной денервацией), возникающей вследствие хронической гипергликемии с поражением волокон вегетативной нервной системы. Клинически это проявляется тахикардией покоя -одним из ранних признаков КАН [14]. Таким образом, удлинение QTc -обязательный спутник КАН, а КАН, в свою очередь, -независимый фактор риска удлинения QTc.…”

Section: интерпретация результатов исследованияunclassified

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Cardiac Autonomic Neuropathy and Hypoglycemia as Independent Predictors of QTc Elongation at Night in Adolescents With Type 1 Diabetes: Cohort Study

Демяненко

Алимова

2019

Vopr. sovr. pediatr.

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Section: обоснованиеunclassified

Section: интерпретация результатов исследованияunclassified

Cardiac Autonomic Neuropathy and Hypoglycemia as Independent Predictors of QTc Elongation at Night in Adolescents With Type 1 Diabetes: Cohort Study

Демяненко

Алимова

2019

Vopr. sovr. pediatr.

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The new face of diabetes mellitus — rhythm and conduction disorders

Tyurypov,

Odnokol,

Kutelev

et al. 2024

Russian Military Medical Academy Reports

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This review article is devoted to changes in heart rhythm against the background of type 2 diabetes mellitus, which is one of the most common endocrine diseases. In recent years, there has been an increasing association between type 2 diabetes mellitus and heart rhythm disorders. Arrhythmias such as tachycardia, bradycardia and atrial fibrillation are common in patients with type 2 diabetes and can have serious consequences on health and quality of life. Type 2 DM is increasingly common worldwide due to the rise in sedentary lifestyles, overweight, abdominal forms of obesity, and diets containing too much fat and carbohydrates. Insulin-independent diabetes is a metabolic disease responsible for autonomic neuropathy of the heart that affects both sympathetic and parasympathetic fibers, which can be explained by the adverse effect of blood glucose levels on heart rate variability (HRV). Although the gold standard is cardiovascular reflex tests to assess cardiovascular autonomic neuropathy, one of the most important is the measurement of heart rate variability (HRV). HRV is the variation between two consecutive contractions: the higher the variation, the higher the activity of the parasympathetic nervous system. A high HRV reflects the fact that a person can constantly adapt to changes in the microenvironment. Thus, low HRV is a marker of cardiovascular risk.

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Cardiac autonomic neuropathy as risk factor of diabetic complications progression

et al. 2023

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Introduction. Diabetes mellitus (DM) is the most common and incapacitating endocrine disorder. Diabetic foot syndrome (DFS) is one of the most serious complications of DM, which is the main cause of nontraumatic lower-extremity amputations. Despite the efforts of the entire medical community, the survival rate of DFS patients with non-healing ulcers and after foot surgery does not exceed 50% over 5 years and is comparable to the survival rates of patients with colorectal cancer.Aim. It has been demonstrated that postsurgical diabetic foot wounds tend to chronization of inflammatory process. The diabetic autonomic neuropathy can be involved in diabetic foot damages. We hypothesized that progression of cardiovascular autonomic neuropathy (CAN) leads to aggressive microvascular complications of diabetes and delay the postsurgical wound healing in diabetic foot patients during 2 years of observation.Materials and methods. We examined 94 outpatients with postsurgical diabetic foot wounds and observation period of two years. The clinical neurological examination and standard cardiovascular autonomic reflex tests with identification of severe/advanced abnormalities were performed at baseline and after 2 years. The progression of CAN was diagnosed in cases of an increase in the amount of cardiovascular autonomic reflex tests by 1 score and more. The unsatisfactory result of wound treatment was detected in patients with wound healing delay and new cases of surgery debridement, foot amputations and Charcot foot during 2 years of observation.Results. The mean duration of diabetes was 10.7 year, HbA1c 8.3%, LDL-Chol 3.3 mmol/l, TG 1.8 mmol/l. The 51.1% patients had been amputated in the level of foot, 48.9% patients had surgery debridement. All patients had CAN, confirmed/severe forms in 57.4% cases. The progression of CAN was found in 22.3% patients, the most of them with functional stage at baseline. The aggressive course of CAN increased the risk of progression of diabetic sensomotor neuropathy (OR = 14.6; 95% CI 3.0–70.5; p = 0.0006), nephropathy (OR = 22.4; 95% CI 3.4–147.4; p = 0.0009) and unsatisfactory result of wound treatment (OR = 40; 95% CI 6.0–268.5; p = 0.0001).Conclusions. The patients with diabetic foot surgery wounds has high risk of confirmed/severe CAN and its progression during 2 years. The aggressive course of CAN associates with unsatisfactory result of wound treatment and progression of microvascular diabetic complications.

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Predictors and diagnosis of cardiac autonomic nervous dysfunction in patients with type 1 and type 2 diabetes mellitus

Cited by 4 publications

References 61 publications

Cardiac Autonomic Neuropathy and Hypoglycemia as Independent Predictors of QTc Elongation at Night in Adolescents With Type 1 Diabetes: Cohort Study

Cardiac Autonomic Neuropathy and Hypoglycemia as Independent Predictors of QTc Elongation at Night in Adolescents With Type 1 Diabetes: Cohort Study

The new face of diabetes mellitus — rhythm and conduction disorders

Cardiac autonomic neuropathy as risk factor of diabetic complications progression

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