Time- and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes

Cha, Seon-Ah; Park, Young Jun; Yun, Jae‐Seung; Lee, Seung Hwan; Ahn, Yu‐Bae; Kim, Sung‐Rae; Ko, Seung‐Hyun

doi:10.1016/j.diabres.2018.07.001

Cited by 36 publications

(30 citation statements)

References 41 publications

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“…Likewise, Razainskaite-Virbichiene et al (36) demonstrated that in patients with T1DM, the parameters of time domain in supine position have a coefficient of variation <1.65, reflecting a sensitivity of 94.3% and specificity of 91.5% for the diagnosis of CAN. Additionally HRV variables were independent predictors for developing cardiovascular disease (CVD) in patients with T2DM (28,30,34,36). These findings are in agreement with our results that showed improvement in rest HRV parameters in response to short interventional treatment, as opposed to dynamic tests that remained unchanged.…”

Section: Discussionsupporting

confidence: 90%

“…Resting heart rate variability was advocated by some authors as a sensitive and specific method for diagnosis of cardiovascular dysautonomia. Besides that, it is easier to be performed than dynamic tests and does not need patient collaboration (28)(29)(30)(31)(32)(33)(34)(35). Takase et al (28) found that a cut-off point <30ms in SDNN parameter has a sensitivity of 72% and specificity of 92% for CAN diagnosis in patients with type 2 diabetes, while Ziegler et al (30) showed that HF index was more sensitive than functional tests to detect precocious autonomic disorder in patients with diabetes, using 0,892 as a cut-off.…”

Section: Discussionmentioning

confidence: 99%

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Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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BackgroundCardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients.MethodsWe performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30–60 ng/ml were given 4,000 IU/day for 12 weeks.ResultsThere was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively).ConclusionOur pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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“…A teljesítményspektrum-analízis során a szívfrekvencia-variabilitást nyugalmi helyzetben vizsgálva az alacsony frekvenciájú (0,04-0,15 Hz) és a magas frekvenciájú (0,15-0,4 Hz) komponenseket vizsgálják. Az alacsony frekvenciájú komponensek a paraszimpatikus, míg a magas frekvenciájúak a szimpatikus aktivitást jellemzik [27].…”

Section: A Szívfrekvencia-variabilitás Vizsgálataunclassified

A diabeteses cardialis autonóm neuropathia diagnosztikája

et al. 2019

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Cardiac autonomic neuropathy (CAN) is a common complication in type 1 and 2 diabetes and is defined as the impairment of autonomic control of the cardiovascular system. CAN is strongly associated with increased mortality, and in some studies with morbidity of vascular complications, such as stroke, coronary artery disease and myocardial infarction. At the early stages, CAN can be subclinical and it becomes clinically evident as the disease progresses. Subclinically, the disease is defined by cardiovascular reflex testing, which may have prognostic implications. Clinically, the impairment in autonomic function is associated with resting tachycardia, exercise intolerance, orthostatic hypotension, syncope, intraoperative cardiovascular instability, silent myocardial infarction and ischemia, and increased mortality. Although very common and serious, CAN is a frequently overlooked complication of diabetes. Because the progression of cardiovascular denervation is partly reversible or can be slowed down in the early stages of the disease, recent guidelines strongly recommend screening for CAN in patients with diabetes. In this review we summarize the diagnostic tools suggested in the screening for diabetic CAN. Orv Hetil. 2019; 160(35): 1366–1375.

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“…HRV represents one of the most promising markers. A joint European Society of Cardiology and North American Society of Pacing and Electrophysiology task force de ned and established standards of measurement, physiological interpretation, and clinical use of HRV, and the most widely used methods can be grouped under the time domain and frequency domain methods [4,5]. Established clinical data based on numerous studies consider HRV have been proven useful in detecting CAN in diabetes patients [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Although HRV and ESC are validated and can serve as screening tools for CAN in patients with diabetes [5,[12][13][14][15][16], there is paucity of information that focuses on its role in estimating CAN severity in patients with diabetes who was already diagnosed with CAN in outpatient clinics, owing to the possible bene ts of exploring the role of the CV autonomic function on subsequent CV events and the consequent development of therapeutic strategies to reduce the prevalence of CV events.…”

Section: Introductionmentioning

confidence: 99%

Integrating heart rate variability and electrochemical skin conductance as severity screening of cardiovascular autonomic neuropathy in type 2 diabetes

Lai

Cheng

Tsai

et al. 2020

Preprint

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Background: Clinical studies show that either heart rate variability (HRV) or electrochemical skin conductance (ESC) alone can serve as a simple and objective method for screening cardiovascular autonomic neuropathy (CAN). We tested the hypothesis that combining these two quantitative approaches can provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already suffered from CAN in outpatient clinics.Methods: Each patient received a complete battery of cardiovascular autonomic reflex tests (CARTs), with ESC measured by SUDOSCAN, time domain measured by standard deviation of all normal RR intervals (SDNN) and frequency domain of HRV (low frequency [LF], high frequency [HF], and LF/HF ratio), and peripheral blood studies for vascular risk factors. Severity of CAN was measured by CAN score.Results: The 90 T2DM patients included 50 males and 40 females. Those with more severe CAN had a higher CAN score value (P<0.0001) and lower values in feet ESC (P=0.023) and SDNN (P<0.0001). Stepwise linear regression analysis also showed that feet ESC and SDNN value (P<0.0001 and P<0.0001) were significantly associated with CAN score, respectively.Conclusions: Based on our results, a combination of electrophysiologic biomarkers (SDNN and feet ESC) as a test battery can improve the diagnostic accuracy and reinforce the accuracy in estimating CAN severity and can serve as a time-effective screening service in outpatient clinics.

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Time- and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes

Abstract: Time- and frequency-domain measures of HRV independently predicted cardiovascular outcome in patients with T2DM.

Cited by 36 publications

References 41 publications

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

A diabeteses cardialis autonóm neuropathia diagnosztikája

Integrating heart rate variability and electrochemical skin conductance as severity screening of cardiovascular autonomic neuropathy in type 2 diabetes

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