Differences in heart rate variability in non‐hypertensive diabetic patients correlate with the presence of underlying cerebrovascular disease

Abstract

We previously showed that diabetes contributes to the development of sclerotic lesions in cerebral arteries. In this study, we attempted to clarify whether differences in heart rate variability in non-hypertensive diabetic patients were dependent on the presence or absence of underlying cerebrovascular disease. Thirty diabetic subjects between 40 and 59 years of age and who had no prior history of hypertension were used in this study. Lacunar lesions (LA) were detected with magnetic resonance imaging and atherosclerotic lesions (AS) were detected using intra- and extracranial magnetic resonance angiography, and by ultrasonographic scanning of the carotid artery. Patients underwent a full clinical laboratory screening and a power spectrum analysis of their heart rate variability. Subjects were divided into two groups: those with and without LA. The low frequency/high frequency ratio (LF/HF ratio) was found to be significantly increased (P<0.01) in subjects with LA (2.2 +/- 0.3) compared to those without LA (1.3 +/- 0.1). When subjects were divided into groups based on their presence or absence of AS, high-frequency power was found to be significantly reduced (P<0.05) in the subjects with AS (12.8 +/- 3.4 ms) compared to those without AS (19.4 +/- 1.7 ms). The LF/HF ratio was found to be significantly increased (P<0.05) in the subjects with AS (2.2 +/- 0.3) compared to those without AS (1.4 +/- 0.1). Our data suggested that atherosclerotic lesions in cerebrovascular diseased linked to decrease of vagal nerve activity in non-hypertensive diabetic patients.

Frequency-Dependent Phenotype Modulation of Vascular Smooth Muscle Cells under Cyclic Mechanical Strain

“…In vivo studies have shown that heart rate variability is a significant risk factor in atherosclerosis [30, 31]. Our preliminary findings can lead us to speculate that, apart from the amplitude, the frequency may play an important role in VSMC phenotype alterations in the context of vascular diseases.In vivo, may be through protecting the contractile phenotype VSMCs against transforming to synthetic phenotype, lower heart ratesprevent the process of atherosclerosis, while higher heart rates accelerate its progression.…”

Lipid and endothelium-related genes, ambient particulate matter, and heart rate variability--the VA Normative Aging Study

“…Formations of atheromatous plaques result in atherosclerosis, including coronary atherosclerosis. Many studies have shown that atherosclerosis is significantly associated with decreased HRV 26 27 28 29 30 31. Particle exposure has been shown to influence plaque formation and stability 32.…”

Parasympathetic activity correlates with early outcome in patients with large artery atherosclerotic stroke

“…The present study excluded cardioembolic, undetermined and other determined subtypes because cardiac disease or undetermined disease may interfere with the validity of HRV analysis [12]. Some studies demonstrated that patients with LAC have higher sympathetic activity than control subjects [1,3]. A study by Dutsch et al on post-acute lacunar infarction patients showed stroke patients had lower HF and higher LF/HF [3].…”

“…However, the median time from stroke onset to recruitment was 31 months, and they also included subjects with a history of cardiac events and continued BP lowering agents. In a study by Nagata et al [1], diabetic patients with asymptomatic lacunar infarction had higher LF/HF than those without infarction. The present study included patients with LAC in the acute stage and demonstrated that their autonomic modulations were similar to those of control subjects.…”

“…Autonomic dysfunction is a risk factor for cerebrovascular diseases [1,2]. In prior studies [3][4][5], patients with acute ischemic stroke (AIS) have depressed parasympathetic activity at acute or chronic stages, but the results of sympathetic activity in these patients were conflicting among these studies.…”