QTc and autonomic neuropathy in diabetes: Effects of acute hyperglycaemia and n-3 PUFA

Santini, Vanina; Ciampittiello, G.; Gigli, Fabrizio; Bracaglia, Daniela; Baroni, Alessandra; Cicconetti, Elena; Verri, Cristian; Gambardella, S.; Frontoni, Simona

doi:10.1016/j.numecd.2006.09.006

Cited by 31 publications

(29 citation statements)

References 21 publications

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“…3). A high glycemic status induces the presence of heightened sympathetic and reduced parasympathetic activity, which is supported by previous studies in patients with diabetes mellitus compared to non-diabetes or healthy adults at rest (Liao et al 1995;Santini et al 2007). Generally, HRV parameters decrease in patients with diabetes mellitus (Task Force of the European Society of Cardiology the North American Society of Pacing Electrophysiology 1996; Xhyheri et al 2012), although it is considered that these observations occur with the progression of diabetes mellitus and are probably due to the complication of autonomic neuropathy (Schroeder et al 2005).…”

Section: The Effect Of a High Glycemic Status On The Autonomic Responsupporting

confidence: 71%

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

Kamakura

Maruyama

2016

Tohoku J. Exp. Med.

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A high glycemic status increases the risk for autonomic dysfunction and cardiovascular failure. The aim of this study was to investigate time-dependent changes in the autonomic response and cardiovascular dynamics and the association between the level of hemoglobin A1c (HbA1c) and autonomic response during blood volume reduction. The study population consisted of 26 preoperative participants who were scheduled for autologous blood donation (200-400 mL of whole blood) for intraoperative or postoperative use. These participants without circulatory, respiratory, or brain disease and diabetes mellitus were grouped according to their HbA1c levels: < 6.5% (n = 18) and ≥ 6.5% (n = 8). We measured blood pressure (BP) and analyzed heart rate variability (HRV) to quantify cardiac autonomic regulation throughout blood donation. During blood volume reduction, which was about 10% of the circulating blood volume, the BP and heart rate varied within normal ranges in both groups. The high-frequency (HF) component, an index of parasympathetic nerve activity, and the ratio of low-frequency (LF) to HF components (LF/HF), an index of sympathetic nerve activity, significantly decreased and increased with the progression of blood volume reduction, respectively, in the HbA1c < 6.5% group. In contrast, in the HbA1c ≥ 6.5% group, the HF component did not significantly change, and the increase in the LF/HF ratio was delayed. Time-dependent changes in HRV were related to blood volume reduction only in the HbA1c < 6.5% group. Thus, elevated HbA1c levels are associated with the decrease in the autonomic response induced by blood volume reduction.

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Section: The Effect Of a High Glycemic Status On The Autonomic Responsupporting

confidence: 71%

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

Kamakura

Maruyama

2016

Tohoku J. Exp. Med.

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“…However, this study could not demonstrate a significant association between omega-3 PUFA and HRV in the patients with type 2 DM. In contrast, a small Italian study found that 6 months of omega-3 PUFA treatment in a group of 13 type 2 DM patients partially improved HRV in the frequency domain (Santini et al, 2007). …”

Section: Omega-3 Pufa and Heart Rate Variability In Other Populationsmentioning

confidence: 94%

Omega-3 Polyunsaturated Fatty Acids and Heart Rate Variability

Christensen¹

2011

Front. Physio.

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Omega-3 polyunsaturated fatty acids (PUFA) may modulate autonomic control of the heart because omega-3 PUFA is abundant in the brain and other nervous tissue as well as in cardiac tissue. This might partly explain why omega-3 PUFA offer some protection against sudden cardiac death (SCD). The autonomic nervous system is involved in the pathogenesis of SCD. Heart rate variability (HRV) can be used as a non-invasive marker of cardiac autonomic control and a low HRV is a predictor for SCD and arrhythmic events. Studies on HRV and omega-3 PUFA have been performed in several populations such as patients with ischemic heart disease, patients with diabetes mellitus, patients with chronic renal failure, and in healthy subjects as well as in children. The studies have demonstrated a positive association between cellular content of omega-3 PUFA and HRV and supplementation with omega-3 PUFA seems to increase HRV which could be a possible explanation for decreased risk of arrhythmic events and SCD sometimes observed after omega-3 PUFA supplementation. However, the results are not consistent and further research is needed.

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“…Furthermore, HRV has been shown to be inversely associated with BGL, indicated by negative correlations between both LF and HF component powers and BGL (17). In addition, an increased LF/HF power ratio has been shown during hyperglycemia in controls and diabetics without CAN (18). …”

Section: Introductionmentioning

confidence: 99%

Cardiac Autonomic Dysfunction in Type 2 Diabetes â€“ Effect of Hyperglycemia and Disease Duration

et al. 2014

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Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls and 93 type 2 DM (T2DM) patients were analyzed. HRV was assessed using several time-domain, frequency-domain, and non-linear methods. HRV parameters showed a clear difference between healthy controls and T2DM patients. Hyperglycemia was associated with increase in mean heart rate and decrease in HRV, indicated by negative correlations of BGL and HbA1c with mean RR interval and most of the HRV parameters. Duration of diabetes was strongly associated with decrease in HRV, the most significant decrease in HRV was found within the first 5–10 years of the disease. In conclusion, elevated blood glucose levels have an unfavorable effect on cardiac autonomic function and this effect is pronounced in long-term T2DM patients. The most significant decrease in HRV related to diabetes and thus presence of autonomic neuropathy was observed within the first 5–10 years of disease progression.

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QTc and autonomic neuropathy in diabetes: Effects of acute hyperglycaemia and n-3 PUFA

Cited by 31 publications

References 21 publications

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

Elevated HbA1c Levels Are Associated with the Blunted Autonomic Response Assessed by Heart Rate Variability during Blood Volume Reduction

Omega-3 Polyunsaturated Fatty Acids and Heart Rate Variability

Cardiac Autonomic Dysfunction in Type 2 Diabetes â€“ Effect of Hyperglycemia and Disease Duration

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