Autonomic function as indicated by heart rate deceleration capacity and deceleration runs in type 2 diabetes patients with or without essential hypertension

Abstract

PurposeSympathovagal imbalance is a common underlying disorder in hypertension and diabetes. This study characterized autonomic nervous system function, indicated by heart rate deceleration capacity (DC) and deceleration runs (DRs), in patients with type 2 diabetes mellitus (T2DM), with or without concomitant essential hypertension.Subjects and methodsWe recruited 50 healthy subjects, 50 patients with T2DM, and 95 with T2DM and essential hypertension. DC, DRs (DR2, DR4, and DR8, ie, episodes of 2, 4, or 8 consecutive beat-to-beat heart rate decelerations, respectively), and heart rate variability were determined by dynamic electrocardiogram. Biochemical markers of glucose and lipid metabolism, including glycated hemoglobin (HbA1c) and high-density lipoprotein cholesterol (HDL-C), were measured from blood samples.ResultsBoth T2DM groups featured lower DC, SD of all normal-to-normal sinus RR intervals over 24 h (SDNN), root mean square of the successive normal sinus RR interval difference, and all DR values, but higher average heart rate (AHR) and acceleration capacity (AC), than healthy subjects. There were significant associations between the following: DC and HbA1c, systolic blood pressure (SBP), AHR, age, and HDL-C; DR2 and AHR, SBP, and HbA1c; DR4 and HbA1c, age, SBP, and HDL-C; and DR8 and HbA1c, AHR, and age. In both T2DM groups, HbA1c correlated negatively with DC, DR2, and SDNN, and positively with AC and AHR; homeostasis model assessment-insulin resistance index correlated negatively with DC, all DRs, and SDNN, and positively with AC.ConclusionCompared with healthy subjects, T2DM patients with or without essential hypertension have lower DC and DRs. DC and DRs correlate negatively with blood glucose and insulin resistance index.

The association between vitamin D levels and heart rate variability in patients with type 2 diabetes mellitus

“…[29] Studies have already demonstrated the reduced HRV could be regarded as early indicators of cardiac autonomic dysfunction. [7,30,31] This study found that vitamin D levels of T2DM patients in the deficiency group were associated with reduced SDNN, ASDNN, pNN50, LF, HF, SDANN, and rMSSD. Meanwhile, the LF/HF in the deficiency group was significantly higher than those in the sufficiency group.…”

“…[29] Studies have already demonstrated the reduced HRV could be regarded as early indicators of cardiac autonomic dysfunction. [7,30,31]…”

Increased resting heart rate and glucose metabolism in a community population

“…15,16 Increased RHR leads to increased secretion of several inflammatory cytokines, such as highsensitivity C-reactive protein, fibrinogen, and interleukin-6, implying that the general population with high RHR is in a subclinical inflammatory state. [17][18][19][20] Our observational study was conducted among a community-based population and included individuals with no obvious symptoms of discomfort; additionally, all data were from routine physical examinations. Most RHR values in our study population were in the range 57 to 80 beats/minute.…”

“… 15 , 16 Increased RHR leads to increased secretion of several inflammatory cytokines, such as high-sensitivity C-reactive protein, fibrinogen, and interleukin-6, implying that the general population with high RHR is in a subclinical inflammatory state. 17 – 20 …”

Complementary Photoplethysmogram Synthesis From Electrocardiogram Using Generative Adversarial Network

“…Analyses of heart rate and heart rate variability (HRV) have broad biomedical applications ranging from diagnosis of cardiovascular diseases based on arrhythmias [45][46][47] to noninvasive assessment of autonomic nervous system (ANS) activities [48][49][50][51][52]. Experimental evidences for the association between lethal arrhythmias and sympathovagal imbalance have been reported [53][54][55][56][57] and changes in HRV have been associated with derangements in the neural activity of cardiac origin following myocardial infarction [58,59] as well as with the onset of diabetic neuropathy [60,61]. Furthermore, a previous work [62] demonstrated that PPG variability (PPGV) could be used as an alternative to HRV by comparing the similarity between PPGV and HRV.…”