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. 2018 Sep:143:159-169.
doi: 10.1016/j.diabres.2018.07.001. Epub 2018 Jul 10.

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

Seon-Ah Cha  1 , Yong-Moon Park  2 , Jae-Seung Yun  1 , Seung-Hwan Lee  3 , Yu-Bae Ahn  1 , Sung-Rae Kim  4 , Seung-Hyun Ko  5
Affiliations

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

Seon-Ah Cha et al. Diabetes Res Clin Pract. 2018 Sep.

Abstract

Aims: To evaluate the association between impaired heart rate variability (HRV) and cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM).

Methods: A total of 655 patients with T2DM who underwent cardiovascular autonomic function testing were consecutively recruited and followed up prospectively. Time- and frequency-domain HRV were assessed for 5 min by beat-to-beat heart rate recording. We estimated the development of CVD events during a follow-up period.

Results: During a median follow-up of 7.8 years, 9.6% (n = 49) of patients developed CVD (10.6 per 1000 patient-years). The mean age and diabetes duration were 54.9 ± 8.6 years and 9.4 ± 7.3 years, respectively. Patients who had cardiovascular autonomic neuropathy (CAN) had decreased HRV compared with those with normal autonomic function. Multivariable cox hazard regression analysis revealed the lowest 10th percentile of the SD of the normal-to-normal interval (HR 2.62; 95% CI 1.30-5.31), total power (HR 2.81; 95% CI 1.37-5.79), low-frequency power (HR 2.68; 95% CI 1.28-5.59), and high-frequency power (HR 2.24; 95% CI 1.09-4.59) were significant predictors for developing CVD in patients with T2DM.

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

Keywords: Cardiac autonomic neuropathy; Cardiovascular outcome; Heart rate variability; Type 2 diabetes.

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Conflict of interest statement

Conflict of interest

The authors declare that there are no relevant conflicts of interest

Figures

Fig 1.
Fig 1.. Study outline
T2DM type 2 diabetes, AFT, autonomic function test.
Fig 2.
Fig 2.. The results of frequency-domain parameters of heart rate variability and cardiac autonomic neuropathy stage (estimated means with standard of error means).
CAN, cardiovascular autonomic neuropathy, LF, low field, HF, high field.
Fig 3.
Fig 3.. Cumulative hazard rate of the development of cardiovascular disease according to total power in patients with type 2 diabetes A. Total power (ms2). (log-rank p = 0.004) B. LF power (ms2) (log-rank p = 0.008) C. HF power (ms2) (log-rank p = 0.031) LF, low frequency, HF, high frequency, ms, milliseconds.
See this image and copyright information in PMC

References

    1. American diabetes association. 10. Microvascular Complicatioins and Foot Care: Standards of Medical Care in Diabetes–2018. http://care.diabetesjournals.org/content/41/Supplement_1/S105;2018 [Accessed 17 Jan 2018] - PubMed
    1. Ariza MA, Vimalananda VG, Rosenzweig JL. The economic consequences of diabetes and cardiovascular disease in the United States. Reviews in endocrine & metabolic disorders, 11(2010), pp. 1–10 - PubMed
    1. Caro JJ, Ward AJ, O’Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes care, 25(2002), pp. 476–481 - PubMed
    1. Goff DC Jr, Gerstein HC, Ginsberg HN, Cushman WC, Margolis KL, Byington RP, Buse JB, Genuth S, Probstfield JL, Simons–Morton DG: Prevention of cardiovascular disease in persons with type 2 diabetes mellitus: current knowledge and rationale for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol, 99(2007):4i–20i - PubMed
    1. Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW: Achievement of goals in U.S. diabetes care, 1999–2010. N Engl J Med. 368(2013), pp. 1613–1624 - PubMed