Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy

Howorka, Kinga

doi:10.1016/s0008-6363(97)00040-0

Cited by 108 publications

(88 citation statements)

References 40 publications

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“…In contrast to other findings [52,62,63,64,65] this study did not show any covariation between age, physical activity, sex, or BMI and HRV parameters. Possible explanations could be, that the patients in our study consisted of a small and relatively homogenous group according to BMI and age.…”

Section: -H Time Domain Analysis Of Hrvcontrasting

confidence: 99%

Effects on heart rate variability of metoprolol supplementary to ongoing ACE-inhibitor treatment in Type I diabetic patients with abnormal albuminuria

et al. 2002

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difference in heart rate between inspiration and expiration; LF, square root of power of the low frequency oscillation; LF power, power of the low frequency oscillation; Mean RR, mean of all normal RR intervals; Mean RR D-N, difference between awake and sleep time in mean RR; RSA, respiratory sinus arrhythmia; SDANN, standard deviation of the mean RR in all 5 min segments in a 24 h period; SDNN, standard deviation of all normal RR intervals; SDNN index, mean of SD's calculated on 5 min of RR intervals during a 24 h period; SE, standard error; sNN6%, number of successive RR interval differences > 6%, standardized to 24 h; sNN50, number of successive RR interval differences > 50 ms, standardized to 24 h; UAE, urine albumin excretion. AbstractAims/hypothesis. Diabetic nephropathy is associated with a high risk of cardiac mortality including sudden death. This is presumably related to an imbalance between sympathetic and parasympathetic tone resulting in a decreased heart rate variability (HRV). In nondiabetic patients a decreased HRV is known to be a strong predictor of cardiovascular death. Studies in non-diabetic patients have shown that β-blockers improve HRV parameters known to reflect parasympathetic function. The aim of our study was to investigate effects of additional β-blocker treatment on: cardiac autonomic function, blood pressure, and urine albumin excretion in ACE-inhibitor treated Type I (insulin-dependent) diabetes mellitus patients with abnormal albuminuria. Methods. We studied the effects of 6 weeks treatment with metoprolol (100 mg once daily, zero order kinetics formulation) in 20 patients participating in a randomised, placebo controlled, double blind, crossover trial. Patients were simultaneously monitored under ambulatory conditions with 24-h Holter-monitoring, Corresponding author: Dr. E. Ebbehøj, Medical Department M (Diabetes and Endocrinology), Aarhus Kommunehospitalet, DK-8000 Aarhus Denmark, E-mail: e.ebbehoj@dadlnet.dk Abbreviations: AMBP, Ambulatory blood pressure; CCVHF, coefficient of component variance for HF; CCVLF, coefficient of component variance for LF; HF, square root of power of the high frequency oscillation; HF power, power of the high frequency oscillation; HRV, heart rate variability; HRV index, geometric index of total variability in a 24 h period; I-E diff, Diabetologia (2002) 45:965-975 DOI 10.1007 Effects on heart rate variability of metoprolol supplementary to ongoing ACE-inhibitor treatment in Type I diabetic patients with abnormal albuminuria 24-h ambulatory blood pressure recording, and 24-h fractionated urine collections. Heart rate variability was assessed by four different methods; ambulatory HRV analysis was carried out by spectral and time domain analysis, and on days of investigation short-term spectral analysis and bed-side tests were carried out. Results. Metoprolol treatment improved in vagal tone assessed by short-term spectral analysis. The 24-h ambulatory HRV analysis showed improvement in some parameters reflecting vagal function. A minor decrease in...

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Section: -H Time Domain Analysis Of Hrvcontrasting

confidence: 99%

Effects on heart rate variability of metoprolol supplementary to ongoing ACE-inhibitor treatment in Type I diabetic patients with abnormal albuminuria

et al. 2002

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“…Although Meyer et al reported improvements in whole-body oxygen uptake capacity in heart failure patients following HIT exercise training (16), the present study indicates that the regular application of 4-8 exercise bouts of 30 s is insufficient to stress mitochondrial respiration in peripheral skeletal muscle (Table 2). However, this lack of response might also be attributed to our selected subject population, as it has been reported that genetic factors (67), older age (68) and diabetes-related co-morbidities attenuate the adaptive response in VO 2peak (14,61,64,69). Therefore, larger-scale studies are needed to gain more insight into the muscle fibre-type-specific adaptation following resistance, interval, endurance or combined types of exercise training in different T2D subpopulations.…”

Section: Discussionmentioning

confidence: 97%

“…It has been reported that the adaptive response to exercise training is strongly determined by the presence of clinical signs of (autonomic) neuropathy and/or cardiorespiratory deconditioning (14). Therefore, the presence of co-morbidities should be taken into account when tailoring an exercise programme for longstanding, insulin-treated T2D patients.…”

Section: Introductionmentioning

confidence: 99%

Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

Praet¹,

Jonkers²,

Schep³

et al. 2008

European Journal of Endocrinology

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Objective: To determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned, type 2 diabetes (T2D) patients with polyneuropathy. Design: Short-term, single-arm intervention trial. Methods: Eleven male T2D patients (age: 59.1G7.5 years; body mass index: 32.2G4.0 kg/m 2 ) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (W max ), whole-body peak oxygen uptake (VO 2peak ) and muscle oxidative capacity (MUOX), intramyocellular lipid (IMCL) and glycogen (IMCG) storage, and systemic inflammation markers were determined before and after training. Daily exogenous insulin requirements (EIR) and historic individualized EIR were gathered and analysed. Results: MUST and W max increased with 17% (90% confidence intervals 9-24%) and 14% (6-21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (K9.7 to K1.4). EIR dropped with 5.0 IU/d (K11.5 to 1.5) compared with baseline. A decline of respectively K0.7 mmol/l (K2.9 to 1.5) and K147 mmol/l (K296 to 2) in fasting plasma glucose and non-esterified fatty acids concentrations were observed following the intervention, but these were not accompanied by changes in VO 2peak , MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor-a and/or cholesterol concentrations. Conclusion: Short-term resistance and interval exercise training is feasible in deconditioned T2D patients with polyneuropathy and accompanied by moderate improvements in muscle function and blood pressure. Such a specific exercise regimen may provide a better framework for future exercise intervention programmes in the treatment of deconditioned T2D patients.

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“…The importance of regular and sustained exercise regimen Olumide Olatubosun Rowaiye et al, Baroreceptor sensitivity and diabetes mellitus Not investigated in study -ALA -alpha-lipoic acid; BP -blood pressure; BPV -blood pressure variability; CAN -cardiovascular autonomic neuropathy; c-Fos-ir -c-Fos-immunoreactive; DM -diabetes mellitus; ECG -electrocardiography; HMG-CoA -3-hydroxy-3-methylglutaryl coenzyme A; ICV -intracerebroventricular; MABP -mean arterial blood pressure; MI -myocardial infarction; nNOS -neuronal nitric oxide synthase; NTS -nucleus tractussolitarius; RVLM -rostral ventrolateral medulla; STZ -streptozotocin in the management of the cardiovascular risks associated with DM cannot be overemphasized. Regular exercise has been shown to improve HRV parameters in patients with CAN (Table 4) with a deterioration of those parameters within weeks of complete exercise withdrawal [109]. [90] also appears to be useful in improving BRS in DM patients regardless of the duration (except of course in those with marked CAN).…”

Section: Clinical Perspective On Interventional Modalitiesmentioning

confidence: 99%

Baroreceptor sensitivity and diabetes mellitus

Rowaiye

Jankowska²,

Ponikowska³

2013

Cardiol J

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Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy

Cited by 108 publications

References 40 publications

Effects on heart rate variability of metoprolol supplementary to ongoing ACE-inhibitor treatment in Type I diabetic patients with abnormal albuminuria

Effects on heart rate variability of metoprolol supplementary to ongoing ACE-inhibitor treatment in Type I diabetic patients with abnormal albuminuria

Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training

Baroreceptor sensitivity and diabetes mellitus

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