Abstract
Heart rate variability (HRV) is a method used to evaluate the presence of cardiac autonomic neuropathy (CAN) because it is usually attributed to oscillations in cardiac autonomic nerve activity. Recent studies in other pathologies suggest that HRV indices are strongly related to mean heart rate, and this does not depend on autonomic activity only. This study aimed to evaluate the correlation between the mean heart rate and the HRV indices in women patients with well-controlled T2DM and a control group. HRV was evaluated in 19 T2DM women and 44 healthy women during basal supine position and two maneuvers: active standing and rhythmic breathing. Time-domain (SDNN, RMSSD, pNN20) and frequency-domain (LF, HF, LF/HF) indices were obtained. Our results show that meanNN, age, and the maneuvers are the main predictors of most HRV indices, while the diabetic condition was a predictor only for pNN20. Given the known reduced HRV in patients with T2DM, it is clinically important that much of the HRV indices are dependent on heart rate irrespective of the presence of T2DM. Moreover, the multiple regression analyses evidenced the multifactorial etiology of HRV.
Highlights
Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia due to alterations in the production and action of the hormone insulin, which is related to neuropathy and cardiovascular comorbidities [1]
T2DM patients have an increase in the hazard ratio for cardiovascular mortality between 60–70 years, which is associated with the development of cardiac autonomic neuropathy or “CAN” [5]
This study aimed to evaluate the correlation between the mean heart rate and the Heart rate variability (HRV) indices in women patients with well-controlled T2DM and a control group
Summary
Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia due to alterations in the production and action of the hormone insulin, which is related to neuropathy and cardiovascular comorbidities [1]. CAN is one of the most prevalent diabetes comorbidities, related to important causes of cardiac death such as lethal arrhythmias, silent myocardial ischemia, and sudden cardiac death [6] This type of dysautonomia is characterized by sympathovagal imbalance, in which sympathetic activity predominates over parasympathetic activity [7], inducing an increase in heart rate and blood pressure [8] at the systemic level, and generating alterations in the cardiac conduction system and myocardial contractility [9]. Some studies have found a close and direct dependence of HRV on average HR in healthy human subjects in rest [11,12] and during cardiovascular reflex testing (the Ewing battery) [13,14], animal models and isolated heart tissue [15]. The relation between HRV and average HR is not well understood in healthy human subjects, and even less so in the presence of pathology
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