Noninvasive exploration of Cardiac Autonomic Neuropathy by heart rate and blood pressure variability analysis in Type 2 Diabetic patients

  • Tallat Naz 1. SMC, Jinnah Sindh Medical University 2. Dow University of Health Sciences https://orcid.org/0000-0002-8693-9435
  • Noor un Nisa Memon SMC, Jinnah Sindh Medical University
  • Kamran Afzal College of Medicine, Majmaah University
  • Ambreen Shakir Karachi Institute of Medical Sciences
Keywords: Cardiac autonomic neuropathy, Diabetic neuropathy, Heart rate variability

Abstract

Objectives: To determine the prevalence of asymptomatic cardiac autonomic neuropathy and its association with risk factors among patients with Type-2 diabetes mellitus (T2DM)

Methods: The present case-control study was conducted at Department of Medicine, Civil Hospital, Dow University of Health Sciences (DUHS), Karachi, Pakistan during the period September` 2016 to May` 2017. After taking informed consent, subjects from both genders, 72 healthy controls and 72 clinically diagnosed T2DM diabetic patients, age between 30-65 years were selected by non-probability sampling technique. After taking medical history and demographics, Cardiac Autonomic Neuropathy (CAN) was identified by using Ewing`s cardiac autonomic reflex tests (CARTs) and association of risk factors was also investigated.

Results: Severe CAN was identified in 13.9% of T2DM patients while in none of the healthy controls. HR response to deep breathing test was most sensitive (sensitivity= 90%) among all tests. The most common symptoms were Numbness (75.9%) and constipation (69%), resting heart rate and diabetes duration was significantly associated with DCAN.

Conclusions: CAN was highly prevalent in diabetic population that may lead to nephropathy and retinopathy in future. It is highly recommended to use sensitive and simple CARTs in clinics for early detection and early treatment of CAN.

doi: https://doi.org/10.12669/pjms.37.4.3675

How to cite this:
Naz T, Memon NN, Afzal K, Shakir A. Noninvasive exploration of Cardiac Autonomic Neuropathy by heart rate and blood pressure variability analysis in Type 2 Diabetic patients. Pak J Med Sci. 2021;37(4):1020-1024.  doi: https://doi.org/10.12669/pjms.37.4.3675

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Tallat Naz, 1. SMC, Jinnah Sindh Medical University 2. Dow University of Health Sciences

Power Lab Instructor

Department of Physiology

SMC, Jinnah Sindh Medical University

Karachi, Pakistan

Noor un Nisa Memon, SMC, Jinnah Sindh Medical University

Assistant Professor,

Department of Physiology

SMC, Jinnah Sindh Medical University

Karachi, Pakistan

Kamran Afzal, College of Medicine, Majmaah University

Lecturer,

Department of Physiology

College of Medicine, Majmaah University,

Saudi Arabia

Ambreen Shakir, Karachi Institute of Medical Sciences

Lecturer

Department of Medical Education 

Karachi Institute of Medical Sciences

Karachi, Pakistan

Published
2021-05-06
How to Cite
Naz, T., Memon, N. un N., Afzal, K., & Shakir, A. (2021). Noninvasive exploration of Cardiac Autonomic Neuropathy by heart rate and blood pressure variability analysis in Type 2 Diabetic patients. Pakistan Journal of Medical Sciences, 37(4). https://doi.org/10.12669/pjms.37.4.3675
Section
Original Articles