Heart rate variability and circadian variations in type 1 diabetes mellitus

Kardelen, Fırat; Akçurin, Gayaz; Ertuğ, Halil; Akçurin, Sema; Bircan, İffet

doi:10.1111/j.1399-543x.2006.00141.x

Cited by 57 publications

(57 citation statements)

References 14 publications

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“…As there could be no comparable augmentation of adrenergic tone in isolated myocytes, underlying contractile depression was uncovered in the cell preparation. Chronic increased cardiac adrenergic tone is also present in type 1 diabetic patients [37,38] and this can account for the reduced adrenergic responsiveness of diabetic hearts. Elevated sympathetic tone might also contribute to the gradual development of diabetic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Cardiomyopathy in OVE26 Mice Shows Mitochondrial ROS Production and Divergence Between In Vivo and In Vitro Contractility

Song

Du²,

Prabhu³

et al. 2007

Rev Diabet Stud

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■ AbstractMany diabetic patients suffer from a cardiomyopathy that cannot be explained solely by poor coronary perfusion. This cardiomyopathy may be due to either organ-based damage like fibrosis, or to direct damage to cardiomyocytes. Mitochondrial-derived reactive oxygen species (ROS) have been proposed to contribute to this cardiomyopathy. To address these questions, we used the OVE26 mouse model of severe type 1 diabetes to measure contractility in isolated cardiomyocytes by edge detection and in vivo with echocardiography. We also assessed the source of ROS generation using both a general and a mitochondrial specific indicator. When contractility was assayed in freshly isolated myocytes, contraction was much stronger in control myocytes. However, contractility of normal myocytes became weaker during 24 hours of in vitro culture. In contrast, contractility of diabetic OVE26 myocytes remains stable during culture. Echocardiography revealed normal or hyperdynamic function in OVE26 hearts under basal conditions but with a sharply reduced response to isoproterenol, a β-adrenergic agonist. For ROS generation, we found that ROS production in diabetic myocytes was elevated after exposure to either high glucose or angiotensin II (AngII). Superoxide detection with the mitochondrial sensor MitoSOX Red confirmed that mitochondria are a major source of ROS generation in diabetic myocytes. These results show that contractile deficits in OVE26 diabetic hearts are due primarily to cardiomyocyte impairment and that ROS from mitochondria are a cause of that impairment.

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Section: Discussionmentioning

confidence: 99%

Diabetic Cardiomyopathy in OVE26 Mice Shows Mitochondrial ROS Production and Divergence Between In Vivo and In Vitro Contractility

Song

Du²,

Prabhu³

et al. 2007

Rev Diabet Stud

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“…Clinical and experimental studies have shown that spectral power in the HF range of HRV reflects parasympathetic activity (2,42); however, the interpretation of the LF range is controversial (2,42,44). Diabetes in humans is associated with a reduction in HRV (24,31,35), which is thought to be detrimental to cardiovascular health. In rats, there is evidence for a reduction in HRV and its HF component in association with insulin-deficient diabetes (19,28).…”

Section: Discussionmentioning

confidence: 99%

Deficiency in angiotensin AT1a receptors prevents diabetes-induced hypertension

Wichi

Farah²,

Chen³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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The renin-angiotensin system has been implicated in the etiology of the cardiovascular complications of diabetes. Our studies extend these findings to show a specific role for angiotensin AT1a receptors in mediating diabetes-induced hypertension. Male angiotensin AT1a knockout (AT1aKO) and wild-type (AT1aWT) mice with arterial telemetric catheters were injected with streptozotocin (STZ; 150 mg/kg ip). The STZ dose was selected on the basis of a dose-response experiment in C57/BL mice. Blood glucose, water intake, body weight, blood pressure (BP), and heart rate (HR) were measured over a 2-wk period. Estimates of BP and HR variance (BPV and HRV) and their low-and high-frequency domains were also determined. STZ induced similar levels of hyperglycemia and polydypsia in the groups. Mean arterial pressure (MAP) was increased from 100 Ϯ 6 to 124 Ϯ 6 mmHg in diabetic AT1aWT. MAP was unchanged in AT1aKO (80 Ϯ 4 vs. 85 Ϯ 5 mmHg, basal vs. STZ). Treatment with an ACE inhibitor, captopril, produced a greater reduction in MAP (Ϫ18%) in diabetic AT1aWT than in AT1aKO (Ϫ3.4%). BPV was lower in AT1aKO (19 Ϯ 0.5 vs. 9 Ϯ 2 mmHg 2 , AT1aWT vs. AT1aKO). Diabetes reduced BPV but only in AT1aWT (19 Ϯ 0.5 vs. 8 Ϯ 1 mmHg 2 , basal vs. STZ). There were no changes in HR in either group. In AT1aKO, STZ increased HRV and its high-frequency domain with no changes seen in AT1aWT. Results document that ANG AT1a receptors are critical in diabetes-induced hypertension and in cardiac autonomic responses. cardiovascular; heart rate; blood pressure; renin-angiotensin system; mice; autonomic function; streptozotocin; diabetes DIABETES MELLITUS IS A RISK factor for the development of cardiovascular disease, such as hypertension, atherosclerosis, and congestive heart failure. Mortality rates are greater in diabetic compared with nondiabetic persons, and cardiovascular disease in diabetic patients further increases the risk. The hallmark symptom for diabetes is hyperglycemia, resulting from ␤-cell damage (Type 1) or insulin resistance (Type 2). Hyperglycemia is thought to be a major determinant in the development of longterm complications of diabetes, and treatment is focused on strict glycemic control (1, 23). However, there are interactions with the renin-angiotensin system (RAS), which contribute to diabetesinduced organ damage (8,23,43,53).The RAS plays an important role in the regulation of blood pressure and volume, mainly via the actions of ANG II. Most of the cardiovascular effects of ANG II are mediated by AT1 receptors, which are present in vasculature, brain, heart, and other tissues. AT1 receptors exist as two subtypes, AT1a and AT1b, in mice and rats (33). Studies of the functional role of AT1a receptors have relied on gene deletion (30) or gene silencing (5) methods, because it is not possible to pharmacologically distinguish AT1 receptors. ANG AT1a-deficient mice show low blood pressure, altered renal and autonomic function, and increased sodium sensitivity (6,30,45,46,49,50).Diabetes is associated with activation of the RAS in both h...

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“…This phenomenon was observed in healthy subjects. In elderly patients circadian HRV variation is disturbed for example in arterial hypertension (HA) or diabetes mellitus (DM) [20,24,25].…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability in patients with decompensated liver cirrhosis – a pilot study

Białkowska¹,

Poliwczak²,

Jabłkowski³

et al. 2012

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Introduction: Cirrhosis is associated with many disorders of the cardiovascular system defined "cirrhotic cardiomyopathy". They concern, among others autonomic imbalance. One of the ways to evaluate these disorders is to study the heart rate variability (HRV). Abnormal HRV values occur in hypertension, ischemic heart disease, post myocardial infarction and heart failure. Are one of the prognostic factors. Aim: Evaluation of parameters of HRV in 24-hour Holter monitoring in patients with decompensated cirrhosis. Material and methods: The study included 18 patients with decompensated cirrhosis and the control group consisted of 16 healthy subjects. Enrolled were performed 24-hour Holter ECG. Heart rate variability parameters, were estimated during whole recording period, separately for night resting and morning activity hours. Results: There have been significant differences in almost all, both time and frequency HRV parameters between the two groups for follow-up clock. Similar results were obtained by comparing the HRV separately for the night and morning with a control group. The control group achieved statistically significant differences between all the time parameters of HRV at night compared with morning. Frequency parameters showed no significant differences. In patients with cirrhosis demonstrated such differences for the average time NN, SDNN, SDANN, Tr-I, Tinn and ULF. In a 24-hour observation of HRV parameters did not differ significantly depending on the grade in Child-Pugh classification. Conclusions: Patients with decompensated cirrhosis showed significantly lower HRV parameters than healthy volunteers. In addition, disturbances of circadian distribution showed

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Heart rate variability and circadian variations in type 1 diabetes mellitus

Cited by 57 publications

References 14 publications

Diabetic Cardiomyopathy in OVE26 Mice Shows Mitochondrial ROS Production and Divergence Between In Vivo and In Vitro Contractility

Diabetic Cardiomyopathy in OVE26 Mice Shows Mitochondrial ROS Production and Divergence Between In Vivo and In Vitro Contractility

Deficiency in angiotensin AT1a receptors prevents diabetes-induced hypertension

Heart rate variability in patients with decompensated liver cirrhosis – a pilot study

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