The association between cardiac autonomic neuropathy and heart function in type 2 diabetic patients

Abstract

Aim: Cardiac autonomic neuropathy (CAN) is a common and important chronic complication in diabetic patients. Heart failure resulting from cardiomyopathy is also a lethal complication in diabetic patients. However, data showing the exact association between CAN and heart failure in diabetic patients are relatively scarce. Therefore, our study aimed to determine the association between the parameters assessing CAN and heart function in diabetic patients.

Method: The medical records of type 2 diabetic patients who underwent an autonomic function test with heart rate variability (HRV) and echocardiography were reviewed from January 2018 to December 2018. A total of 100 type 2 diabetic patients were included, and the association between the parameters assessing CAN and heart function was analysed.

Results: Among the 100 analysed patients, 65 were diagnosed with CAN and 26 showed diastolic dysfunction. Moreover, 19 (73.1%) diabetic patients with diastolic dysfunction were complicated with CAN. The occurrence of diastolic dysfunction was higher in diabetic patients with CAN than in diabetic patients without CAN (29.2% vs 20.0%, p < 0.05), and the occurrence of CAN was higher in diabetic patients with diastolic dysfunction than in patients without diastolic dysfunction (73.1% vs 62.2%, p < 0.05). However, there were no significant associations between HRV parameters and heart function.

Conclusion: We demonstrated that diastolic dysfunction is more common in diabetic patients complicated with CAN than in diabetic patients without CAN, although several diabetic patients without diastolic dysfunction are also diagnosed with CAN. Moreover, further studies about the long-term serial monitoring of heart function according to the progression of CAN are required to confirm the exact association between CAN and heart function.

KEWWORDS:

• Cardiac autonomic neuropathy
• diabetes
• diastolic dysfunction
• heart function

Acknowledgments

The authors thank the Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital for supporting this study.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional research committee with approval (IRB Approval No. CUH 2019-11-053) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Patient’s informed consent

Informed consent was obtained from all individual participants included in the study when diagnostic examinations were performed.

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This paper was supported by Fund of Biomedical Research Institute, Jeonbuk National University Hospital in part.