Association of cardiac autonomic neuropathy with arterial stiffness in type 2 diabetes mellitus patients

被引:18
作者
Bagherzadeh A. [1 ]
Nejati-Afkham A. [2 ]
Tajallizade-Khoob Y. [3 ]
Shafiee A. [4 ]
Sharifi F. [3 ]
Esfahani M.A. [5 ]
Badamchizade Z. [3 ]
Alatab S. [3 ]
Fakhrzadeh H. [3 ,6 ]
机构
[1] Department of Internal Medicine, Cardiology and Cardiac Electrophysiology, Dr Shariati hospital, Tehran University of Medical Sciences, Tehran
[2] Department of Cardiology, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran
[3] Elderly Health Research Center, Endocrinology and Metabolism population Sciences Institute, Tehran University of Medical Sciences, Dr Shariati Hospital, North Karegar Avenue, 5th floor, Tehran
[4] Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran
[5] Cardiology Department, St alzahr hospital, Isfahan University of Medical Sciences, Isfahan
[6] Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran
关键词
Arterial stiffness; Cardiac autonomic neuropathy; Diabetes mellitus type 2; Heart rate variability; Pulse wave velocity;
D O I
10.1186/2251-6581-12-55
中图分类号
学科分类号
摘要
Background: Diabetic patients are at the risk of cardiac autonomic neuropathy (CAN) and arterial stiffness. This study aimed to investigate the association of heart rate variability (HRV) as an index for CAN and pulse wave velocity (PWV) as an index for arterial stiffness.Methods: Uncomplicated diabetes type-2 patients who had no apparent history of cardiovascular condition underwent HRV and PWV measurements and the results were compared with the control group consisting of non-diabetic peers. Also, the findings were adjusted for the cardiovascular risk factors and other confounding factors.Results: A total of 64 diabetic patients (age= 52.08±8.50 years; males=33 [51.6%]) were compared with 57 controls (age= 48.74±6.18 years; males=25 [43.9%]) in this study. Hypertension, dyslipidemia, and thereby systolic blood pressure and statin use were significantly more frequent in the diabetic group, while the serum levels of cholesterol, HDL-C and LDL-C were significantly higher in the controls. Pulse wave was significantly increased in the diabetic patients (p<0.001). Main HRV parameters were significantly lower in diabetics than in controls. After adjustment for the confounders, PWV and HRV remained significantly different between the groups (p=0.01 and p=0.004, respectively). Multiple logistic regression of the association between pulse wave velocity and HRV index was independently significant both in diabetics and controls.Conclusions: There exists a significant relationship between heart rate variability and arterial stiffness as a measure for atherosclerosis in diabetic patients, although the role of the confounding factors is noteworthy. © 2013 Bagherzadeh et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 23 条
[1]  
Whiting D.R., Guariguata L., Weil C., Shaw J., Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes research and clinical practice, IDF Diabetes Atlas, 94, 3, pp. 311-321, (2011)
[2]  
Laurent S., Boutouyrie P., Asmar R., Gautier I., Laloux B., Guize L., Et al., Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients, Hypertension, 37, 5, pp. 1236-1241, (2001)
[3]  
Maser R.E., Mitchell B.D., Vinik A.I., Freeman R., The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes a meta-analysis, Diabetes Care, 26, 6, pp. 1895-1901, (2003)
[4]  
Secrest A.M., Marshall S.L., Miller R.G., Prince C.T., Orchard T.J., Pulse wave analysis and cardiac autonomic neuropathy in type 1 diabetes: a report from the Pittsburgh Epidemiology of Diabetes Complications Study, Diabetes Technol Ther, 13, 12, pp. 1264-1268, (2011)
[5]  
Camm A.J., Malik M., Bigger J., Breithardt G., Cerutti S., Cohen R., Et al., Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, Circulation, 93, 5, pp. 1043-1065, (1996)
[6]  
Huikuri H.V., Makikallio T.H., Heart rate variability in ischemic heart disease, Auton Neurosci, 90, 1, pp. 95-101, (2001)
[7]  
Sleight P., La Rovere M.T., Mortara A., Pinna G., Maestri R., Leuzzi S., Et al., Physiology and pathophysiology of heart rate and blood pressure variability in humans: is power spectral analysis largely an index of baroreflex gain?, Clin Sci, 88, pp. 103-109, (1995)
[8]  
La Rovere M.T., Pinna G.D., Hohnloser S.H., Marcus F.I., Mortara A., Nohara R., Et al., Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials, Circulation, 103, 16, pp. 2072-2077, (2001)
[9]  
Hansen T.W., Li Y., Staessen J., Jeppesen J., Rasmussen S., Wang J., Et al., Independent prognostic value of the ambulatory arterial stiffness index and aortic pulse wave velocity in a general population, J Hum Hypertens, 22, 3, pp. 214-216, (2007)
[10]  
Hansen T.W., Staessen J.A., Torp-Pedersen C., Rasmussen S., Thijs L., Ibsen H., Et al., Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population, Circulation, 113, 5, pp. 664-670, (2006)