Evaluation of Cardiac Autonomic Control in Patients with Diabetic Nephropathy: Findings from a Cross-sectional Study
DOI:
https://doi.org/10.37506/yhctfx22Keywords:
Diabetic nephropathy, Heart rate variability, Cardiac autonomic neuropathyAbstract
Introduction: Diabetic nephropathy (DN) is one of the most dreaded complications of diabetes mellitus (DM). Patients with DN have a high risk of early mortality and is associated with increased mortality when associated with cardiac autonomic neuropathy (CAN). The aim of this study was to assess cardiac autonomic control in patients with DN.
Methods: A cross-sectional study were conducted in 50 (17 females) outpatients with DN. Cardiac autonomic control was assessed by a monitoring of cardiac activity at supine and standing positions by a Holter EKG. RR interval data were exported in Kubios HRV Standard Software and 5 minute segments were read. HRV were classify according Sammito et al. and cardiac autonomic neuropathy were diagnosed by criteria of Bellavere et al.
Results: Parasympathetic nervous system parameters were in 22, 20 and 21 patients at supine position. Sympathovagal balance was also low in thirty-one patients. At the transition to orthostatic position only parasympathetic parameters such as pNN50 and HF.nu. were reduced significantly. CAN was diagnosed in thirty patients and majority of them were at the severe form (p < 0.0001) and arterial baroreflex was altered in seventeen patients.
Conclusion: Cardiac autonomic control was altered in majority of patient with diabetic nephropathy.
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