Cardiovascular Autonomic Nervous System Function and Aerobic Capacity in Type 1 Diabetes

Hägglund, Harriet; Uusitalo, Arja; Peltonen, Jari; Koponen, Anne S.; Aho, Jyrki M.; Tiinanen, Suvi; Seppänen, Tapio; Tulppo, Mikko P.; Tikkanen, Heikki

doi:10.3389/fphys.2012.00356

Cited by 25 publications

(18 citation statements)

References 52 publications

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“…Hagglund et al. () investigated HRV in 10 T1D and found no association between resting HRV metrics and V̇ O 2max in this group. However, the absence of association was assessed with a small sample size ( n = 10) and with second derivative frequency‐domain metric (i.e., derived from TP); HF power.…”

Section: Introductionmentioning

confidence: 77%

Resting heart rate variability and exercise capacity in Type 1 diabetes

et al. 2017

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People with type 1 diabetes (T1D) have lower exercise capacity (V̇O2max) than their age‐matched nondiabetic counterparts (CON), which might be related to cardiac autonomic dysfunction. We examined whether Heart Rate Variability (HRV; indicator of cardiac autonomic modulation) was associated with exercise capacity in those with and without T1D. Twenty‐three participants with uncomplicated T1D and 17 matched CON were recruited. Heart rate (HR; ECG), blood pressure (BP; finger photo‐plethysmography), and respiratory rate (respiratory belt) were measured during baseline, paced‐breathing and clinical autonomic reflex tests (CARTs); deep breathing, lying‐to‐stand, and Valsalva maneuver. Baseline and paced‐breathing ECG were analyzed for HRV (frequency‐domain). Exercise capacity was determined during an incremental cycle ergometer test while V̇O2, 12‐lead ECG, and BP were measured. In uncomplicated T1D, resting HR was elevated and resting HRV metrics were reduced, indicative of altered cardiac parasympathetic modulation; this was generally undetected by the CARTs. However, BP and plasma catecholamines were not different between groups. In T1D, V̇O2max tended to be lower (P = 0.07) and HR reserve was lower (P < 0.01). Resting Total Power (TP) had stronger positive associations with V̇O2max (R 2 ≥ 0.3) than all other traditional indicators such as age, resting HR, and self‐reported exercise (R 2 = 0.042–0.3) in both T1D and CON. Alterations in cardiac autonomic modulation are an early manifestation of uncomplicated T1D. Total Power was associated with reduced exercise capacity regardless of group, and these associations were generally stronger than traditional indicators.

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Section: Introductionmentioning

confidence: 77%

Resting heart rate variability and exercise capacity in Type 1 diabetes

et al. 2017

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“…However, Hägglund et al (33) found no statistically significant differences for the SD1 index in young adults with DM1 at rest. The authors suggested this may be related to the small sample size used in the study or the fact that individuals analyzed were under adequate control and treatment of blood glucose, which could mask the alterations generated by diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…In the Poincaré plot qualitative analysis, which allows a nonlinear assessment of ANS (16,33,35), was observed a less dispersion of points for the DM1 group compared with the control group. This low dispersion pattern of RR reflects a reduction in HRV, indicating loss of ANS complexity for these individuals (16).…”

Section: ) Rr(n) (Ms) On the X-axis And Rr (N+1) (Ms) On The Y-axismentioning

confidence: 99%

Geometric indexes of heart rate of variability identifies autonomic alterations in young patients with type 1 diabetes mellitus

Souza¹,

Pastre²

2016

Curr Res Cardiol

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ObjeCtiveS:To compare autonomic modulation in young patients with type 1 diabetes mellitus (DM1) (n=20) and healthy control subjects (n=23) using geometric indexes of heart rate variability (HRV) associated with linear domains of time and frequency; and to verify correlations between geometric indexes and those obtained by the time and the frequency domain of diabetic individuals. MethOdS: Heart rate was recorded as beat-to-beat with subjects supine for 30 min. The following indexes were calculated: RRtri, TINN, Poincaré plot, SD1, SD2, SD1/SD2, RMSSD, SDNN, LF and HF (ms²/un) (DM1) (1) because it affects the fibres of the autonomic nerves of the heart and blood vessels, causing heart rate abnormalities and vascular dynamic impairments (2,3), leading to increased mortality (4,5).Changes in the autonomic modulation of DM1 were previously described through heart rate variability (HRV) (6-9), a noninvasive assessment method that measures the oscillation of intervals between consecutive heart beats (RR), which are related to influences from the autonomic nervous system (ANS) on the sinus node (10,11).Most studies that assessed autonomic modulation by HRV included populations with type 2 diabetes mellitus (9,12-15), a population that normally have associated comorbidities that could interfere in autonomic modulation (12). Also, these studies used linear methods of analysis of frequency and time domains (14,15), which present limitations as stationary requirements, and show more sensitivity to interference and ectopic beats when compared with nonlinear methods (16). Nonlinear methods are based on chaos theory and may enable better discrimination between normal and abnormal ANS physiology (6). For example, the Poincaré plot is a method used for geometric and nonlinear analysis of the autonomic modulation (16-18). A previous study involving type 2 diabetic individuals assessed different methods of HRV and reported that geometric methods are more reliable for evaluating the presence of an autonomic diabetic disease (19), and studies that analyze this type of indexes in DM1 population were not deeply explored.Therefore, geometric methods could identify autonomic changes and help to plan a better treatment strategy in DM1 patients. Thus, the aim of the present study was: to compare HRV indexes obtained by geometric methods (RRtri, TINN and Poincaré plot -SD1, SD2 and SD1/SD2), associated to indexes of time domain (RMSSD and SDNN) and frequency domain (LF, HF (ms²/un) and LF/HF), of individuals with DM1 and healthy control subjects; and to verify correlations between geometric indexes and those obtained by the time and the frequency domain of diabetic individuals. MethOdS SubjectsThe present study included 43 young adults who were divided into two groups: the DM1 group (n=20 [nine men, 11 women]) with a mean (± SD) age 22.05±4.35 years, with 10.60±4.81 years of DM1 diagnosis, and a control group with 23 healthy subjects (15 men, eight women) mean age 21.69±2.42 years.The inclusion criteria were absence of cardiorespirato...

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“…The analysis software used was the GraphPad InStat ® . The sampling calculation was based on the correlation value between HRV and VO 2 found in the study by Hägglund et al 20 . Thus, the correlation coefficient value used in this statistical procedure was of 0.64, a statistical power of 80% and alpha of 0.05 was considered.…”

Section: Discussionmentioning

confidence: 99%

Variabilidade da frequência cardíaca e carga máxima atingida no teste de esforço físico dinâmico em homens idosos

Vieira

Felix

Quitério

2012

Rev Bras Med Esporte

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Introduction: One of the benefits provided by regular physical activities seems to be the improvement of cardiac autonomic nervous system modulation. However, the role of physical activity as a determinant factor of the heart rate variability (HRV) is not well-established. Therefore, the aim of this study was to verify whether there was a correlation between resting heart rate and maximum workload reached in an exercise test with HRV indices in elderly men. Methods: A study was carried out with 18 elderly men between the ages of 60 and 70 years. The following evaluations were made: a) Maximal exercise test on a cycle ergometer using Balke treadmill protocol to evaluate the aerobic capacity; b) Heart Rate (HR) and RR Intervals (RRi) registered for 15 minutes at rest, in the supine position. After collection, data were analyzed by time domain (RMSSD index) and by the frequency domain (low (LF) and high (HF) frequency indices and LF/HF ratio). Pearson correlation test was used to verify whether there was a correlation between the maximum workload reached during the exercise test and the HRV indices (p ≤ 0.05). Results: Demographic, physiological, and anthropometric characteristics and the maximum load achieved during exercise test: Age = 63 ± 3.0 years; BMI = 24 ± 2 kg/m2; HR = 63 ± 9 bpm; SBP = 123 ± 19 mmHg; DBP = 83 ± 8 mmHg; maximum workload = 152 ± 29 watts. No correlation was found between the HRV indices with the values of the resting heart rate and the maximum workload reached in the exercise test (p > 0.05). Conclusion: Temporal and spectral indices of heart rate variability are not indicators of aerobic capacity of elderly men evaluated on a cycle ergometer.

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Cardiovascular Autonomic Nervous System Function and Aerobic Capacity in Type 1 Diabetes

Cited by 25 publications

References 52 publications

Resting heart rate variability and exercise capacity in Type 1 diabetes

Resting heart rate variability and exercise capacity in Type 1 diabetes

Geometric indexes of heart rate of variability identifies autonomic alterations in young patients with type 1 diabetes mellitus

Variabilidade da frequência cardíaca e carga máxima atingida no teste de esforço físico dinâmico em homens idosos

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