A Comparative Study of Heart Rate Variability in Diabetic Subjects and Normal Subjects

Mirza, Mudassir; A.N.R., Lakshmi

doi:10.7439/ijbar.v3i8.542

Cited by 21 publications

(20 citation statements)

References 18 publications

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“…Similar results were reported by other studies. 17,[24][25][26][27][28] These results of this study did not observe any expected significant changes about autonomic status when compared between patients and control even after performing SR by the patients.…”

Section: Discussionsupporting

confidence: 56%

“…Among the different HRV outcome measures frequency domain measures of HRV include high frequency (HF) norm which determines vagal modulation & low frequency (LF) norm represents sympathetic modulation on heart and also LF/HF reflects sympathovagal balance of cardiac autonomic control 23,24 . Reduced HRV was reported in T2DM by several studies 17,[25][26][27][28] .…”

Section: Introductionmentioning

confidence: 99%

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Effect of supine rest on cardiac autonomic tone in type 2 diabetes mellitus

Rahman

Ferdousi

2018

J Bangladesh Soc Physiol

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Background: Autonomic nerve dysfunction has been noted in type 2 diabetes mellitus (T2DM). Regular practice of supine rest (SR) may cause improvement of this impaired autonomic nerve function.Objective: To observe the effect of SR on the autonomic nerve activity by analysis of heart rate variability (HRV) in patients with T2DM.Methods: This prospective interventional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU)during 2016 on 30 female diagnosed T2DM patients aged 50-55 years with duration of diabetes of 5-10 years. They performed SR (20 minutes twice daily) for 3 months. The diagnosed patients were selected from the Out Patient Department of Endocrinology, BSMMU, Dhaka. Thirty age matched apparently healthy females who did not perform regular SR, were control. To assess the cardiac autonomic nerve function, HRV parameters of all subjects were recorded by PowerLab. HRV data of all subjects were collected at baseline and also after 3 months follow-up. In addition, urinary level of Vanillyl Mandelic acid (VMA) of all subjects were measured at baseline and at post intervention period for patients. For statistical analysis, paired and independent sample t-tests were done, as applicable.Results: The pre-intervention values of LF normalized unit (LF nu), LF/HF ratio(p<0.01) and urinary VMA were significantly higher(p <0.001) and HF normalized unit (HF nu) was significantly (p<0.01)lower in all diabetic patients compared to control. The post-intervention data showed LF nu, LF/HF ratio and urinary VMA were reduced and HF nu was increased but these changes were not statistically significant (p> 0.05) in diabetic patients.Conclusion: This study concluded that parasympathetic activity decreased, increased sympathetic activity with higher sympathovagal balance indicating autonomic dysfunction in patients with T2DM, which was shown with trend of improvement after regular practice of supine rest of 3 months though statistically not significant.Bangladesh Soc Physiol. 2017, December; 12(2): 65-71

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Effect of supine rest on cardiac autonomic tone in type 2 diabetes mellitus

Rahman

Ferdousi

2018

J Bangladesh Soc Physiol

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“…A dose-response relationship was reported between HbA1c and the measures of overall reduced HRV. The studies concluded that chronic and worsening hyperglycemia causes a decrease in all parameters of HRV that determine early cardiac autonomic dysfunction and parasympathetic loss [7][8][9][10]. It has been previously reported that abnormal HRR is associated with impaired glucose tolerance and increasing fasting blood glucose [11][12][13].…”

Section: Check For Updatesmentioning

confidence: 99%

Elevated Hemoglobin A1C is Significantly Associated with Decreased Post-Exercise Heart Rate Recovery in Patients with Diabetes Mellitus

Hasan¹,

Everman²,

Sheikh³

et al. 2017

Int J Diabetes Clin Res

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Heart Rate Recovery (HRR) has been associated with cardiovascular and all-cause mortality in both healthy individuals and those with diabetes. We examined the association between Hemoglobin A1C (HbA1c) and post-exercise HRR in patients with diabetes. Participants who were free from known cardiac disease or severe orthopedic problems referred to an exercise specialist for a fitness assessment. All participants underwent a graded exercise test using a standard Balke-ware protocol. HRR defined as the decrease in heart rate from peak exercise after one minute of a cool down walk at 2 mph and 0% incline. The most recent HbA1c (within three months) recorded for each patient. This study included 411 individuals with diabetes [age 45 ± 10, 269 (65%) males, 375 (91%) with type 2 diabetes, BMI 31 ± 6, 49% with BMI > 30 kg/m 2 ]. The mean HbA1c was 7.3% ± 1.6 (56 mmol/mol). The participants divided into 4 equal cohorts based on the quartiles of HRR. Using multiple logistic regression, adjusting for age, gender, BMI, metabolic equivalent, beta blocker usage, hypertension, and duration of diabetes, there was a significant association between HbA1c and odds of having a HRR in the lowest quartile, such that for every unit increase in HbA1c, there was 13% increase in odds of being in the lowest HRR quartile (adjusted odds ratio 1.125 [1.002, 1.264]). Among diabetic patients without known cardiac disease, poor glycemic control as measured by elevated HbA1c is significantly associated with decreased post-exercise HRR.

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“…Some studies have shown that there was a correlation between the HbA1c level and HRV at rest (Mirza and Laksmi 2012;Tarvainen et al 2014). In our study, there was a significant relationship among the pre-blood, forward, later, and post-blood donation stages of HF, and among the pre-blood, forward, and later blood donation stages of the LF/HF ratio only in participants with an HbA1c level < 6.5% (Table 3).…”

Section: The Effect Of a High Glycemic Status On The Autonomic Responmentioning

confidence: 99%

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

Kamakura

Maruyama

2016

Tohoku J. Exp. Med.

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A high glycemic status increases the risk for autonomic dysfunction and cardiovascular failure. The aim of this study was to investigate time-dependent changes in the autonomic response and cardiovascular dynamics and the association between the level of hemoglobin A1c (HbA1c) and autonomic response during blood volume reduction. The study population consisted of 26 preoperative participants who were scheduled for autologous blood donation (200-400 mL of whole blood) for intraoperative or postoperative use. These participants without circulatory, respiratory, or brain disease and diabetes mellitus were grouped according to their HbA1c levels: < 6.5% (n = 18) and ≥ 6.5% (n = 8). We measured blood pressure (BP) and analyzed heart rate variability (HRV) to quantify cardiac autonomic regulation throughout blood donation. During blood volume reduction, which was about 10% of the circulating blood volume, the BP and heart rate varied within normal ranges in both groups. The high-frequency (HF) component, an index of parasympathetic nerve activity, and the ratio of low-frequency (LF) to HF components (LF/HF), an index of sympathetic nerve activity, significantly decreased and increased with the progression of blood volume reduction, respectively, in the HbA1c < 6.5% group. In contrast, in the HbA1c ≥ 6.5% group, the HF component did not significantly change, and the increase in the LF/HF ratio was delayed. Time-dependent changes in HRV were related to blood volume reduction only in the HbA1c < 6.5% group. Thus, elevated HbA1c levels are associated with the decrease in the autonomic response induced by blood volume reduction.

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A Comparative Study of Heart Rate Variability in Diabetic Subjects and Normal Subjects

Abstract: Aim:The main objective of this study is to enlighten medical faculty and diabetic patients about neurological and cardiovascular complications in Diabetes and to compare heart rate variability in normal individuals and diabetic patients.

Cited by 21 publications

References 18 publications

Effect of supine rest on cardiac autonomic tone in type 2 diabetes mellitus

Effect of supine rest on cardiac autonomic tone in type 2 diabetes mellitus

Elevated Hemoglobin A1C is Significantly Associated with Decreased Post-Exercise Heart Rate Recovery in Patients with Diabetes Mellitus

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

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