Cardiac autonomic dysfunction in type 2 diabetes: Effect of hyperglycemia and disease duration

Mika P Tarvainen, Tomi P Laitinen, Jukka A Lipponen, David Cornforth, Herbert Jelinek

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunctionof cardiac autonomic regulation and an increased risk for cardiac events. The aimof this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin(HbA1c), and duration of diabetes with cardiac autonomic regulation assessed byHRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position,and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients wereanalyzed. HRV was assessed using several time-domain, frequency-domain, and non-linearmethods. HRV parameters showed a clear difference between healthy controls andT2DMpatients. Hyperglycemia was associated with increase in mean heart rate and decreasein HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval andmost of the HRV parameters. Duration of diabetes was strongly associated with decreasein HRV, the most significant decrease in HRV was found within the first 5'10 years of thedisease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiacautonomic function and this effect is pronounced in long-term T2DM patients. The mostsignificant decrease in HRV related to diabetes and thus presence of autonomic neuropathywas observed within the first 5'10 years of disease progression.
Original languageEnglish
Article number130
Pages (from-to)1-9
Number of pages9
JournalFrontiers in Endocrinology
Volume5
DOIs
Publication statusPublished - Aug 2014

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Hyperglycemia
Type 2 Diabetes Mellitus
Heart Rate
Blood Glucose
Supine Position
Glycosylated Hemoglobin A
Disease Progression
Diabetes Mellitus
Electrocardiography

Cite this

Tarvainen, Mika P ; Laitinen, Tomi P ; Lipponen, Jukka A ; Cornforth, David ; Jelinek, Herbert. / Cardiac autonomic dysfunction in type 2 diabetes : Effect of hyperglycemia and disease duration. In: Frontiers in Endocrinology. 2014 ; Vol. 5. pp. 1-9.
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Cardiac autonomic dysfunction in type 2 diabetes : Effect of hyperglycemia and disease duration. / Tarvainen, Mika P; Laitinen, Tomi P; Lipponen, Jukka A; Cornforth, David; Jelinek, Herbert.

In: Frontiers in Endocrinology, Vol. 5, 130, 08.2014, p. 1-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cardiac autonomic dysfunction in type 2 diabetes

T2 - Effect of hyperglycemia and disease duration

AU - Tarvainen, Mika P

AU - Laitinen, Tomi P

AU - Lipponen, Jukka A

AU - Cornforth, David

AU - Jelinek, Herbert

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N2 - Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunctionof cardiac autonomic regulation and an increased risk for cardiac events. The aimof this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin(HbA1c), and duration of diabetes with cardiac autonomic regulation assessed byHRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position,and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients wereanalyzed. HRV was assessed using several time-domain, frequency-domain, and non-linearmethods. HRV parameters showed a clear difference between healthy controls andT2DMpatients. Hyperglycemia was associated with increase in mean heart rate and decreasein HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval andmost of the HRV parameters. Duration of diabetes was strongly associated with decreasein HRV, the most significant decrease in HRV was found within the first 5'10 years of thedisease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiacautonomic function and this effect is pronounced in long-term T2DM patients. The mostsignificant decrease in HRV related to diabetes and thus presence of autonomic neuropathywas observed within the first 5'10 years of disease progression.

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