IntroductIonThe world's diabetic population in 2010 was 285 million, and has recently been increasing. Diabetes is known to markedly raise morbidity and mortality rates from cardiovascular disease, 1) the risk factors of which include obesity, smoking, stress, old age, and cold stimulation. 2,3) The measurement of the coronary blood flow by cardiac catheterization and positron emission tomography (PET) has suggested that cold stimulation induces contraction of the cardiac microvasculature by sympathetic nerve activity, but the induction of coronary vasoconstriction by cold exposure has not been directly confirmed. 4,5) We experimentally measured heart rate variability (HRV) by plain electrocardiogram (ECG) as an index of the cardiac sympathetic nerve function, and evaluated whether or not it allows the prediction of the risk of myocardial ischemia on cold exposure, which may be exacerbated in diabetes. 6)
Methods
Preparation of diabetic rats and evaluation of agingDiabetes was induced in male Wistar rats (5 weeks old) by administering streptozotocin (STZ, 65 mg/kg once, i.p.). 7) The animals that showed a blood glucose level of 400 mg/dl or higher 20 weeks after STZ administration were regarded as a Diabetes Mellitus (DM) group 8) and compared with controls cared for over the same period without STZ administration (n = 6 for each group).This experiment was carried out with approval by the Institutional Review Board of the Laboratory Animal Resource Center, University of Tsukuba, Japan. Measurement of heart rate variability (HRV) is a non-invasive technique that can be used to investigate functioning of the autonomic nervous system, especially the balance between sympathetic and vagal activities. It is reported that dilatation of coronary microcirculation by augmentation of sympathetic nerve activity (SNA) caused by cold exposure was impaired in diabetes. The question of whether or not SNA in HRV could respond to coronary ischemia was evaluated by cold exposure in diabetic rats. It was found that diabetes with weight loss significantly increased SNA both in baseline and cold exposure, compared with control. A correspondence was also found with coronary ischemia. It can be concluded that measurement of HRV may provide useful information regarding the coronary risk of cold exposure in diabetes. (*English translation of J Jpn Coll Angiol 2012; 52: 295-301)
Cardiac Sympathetic Activity Assessed by Heart Rate Variability Indicates Myocardial Ischemia on Cold Exposure in Diabetes