Heart rate variability evaluation in the assessment of cardiac autonomic neuropathy in patients with type 2 diabetes

ConclusionAssessment of CAN using evaluation of HRV can optimally be performed (and simply realized in clinical practice) using SAHRV based on short ECG recordings during autonomic load imposed by orthoclinostatic test (Supine1–Standing–Supine2) and on postprocessing data analysis using complex indicator called “functional age of ANS”. In the detailed evaluation of sympathovagal balance, it complements the screening assessment with cardiovascular reflex tests (Ewing's battery). Besides the orthoclinostatic load, pronounced vagal provocation using rate-controlled, non-deepened breathing (12 cycles/min) represents a recommended facultative load option increasing the yield of the SAHRV method.The detection and assessment of CAN severity while applying the cumulative indicator of HRV (cumLFHF) showed a good discrimination power in the frontline screening for CAN, albeit without the possibility to distinguish between the sympathetic and vagal branch of ANS.Presented cross-sectional study in type 2 diabetes mellitus demonstrated a significant autonomic dysfunction in majority patients examined, independently of diabetes duration. It supports the recommendation to assess the ANS integrity in type 2 diabetes already at diagnosis, within the initial staging of the illness. The severity of CAN correlates well with metabolic control of diabetes as evaluated by glycated hemoglobin.
Source: Cor et Vasa - Category: Cardiology Source Type: research