The Detection Of Cardiac Autonomic Neuropathy And Its Relationship To Other Chronic Complication In Diabetic Patients

To evaluate their sensitivity and correlation by studying cardiovascular reflex tests and other detective methods of cardiac autonomic neuropathy in diabetic patients, as well as investigate the relationship between cardiac autonomic neuropathy and other chronic complication in diabetic patients. Methods Cardiovascular reflex tests(including Ewing scores, Ewing scores ~ 1 means abnormal), squatting test, heart rate variability (H1RV), the changes of ambulatory blood pressure monitoring(ABPM), urinary albumin excretion rate(UAER), nerve conduction velocity and retina examination were performed in 51 diabetes mellitus, 45 healthy controls. Diabetic patients were classified according to UAER (normoalbuminuria, micro albuminuria, macroalbuminuria), nerve conduction velocity, retina examination and diabetes duration. Results The analysis revealed a significant correlation between squatting test markers (SqTv, SqTs), HRV time-domain marker(SDN7N) , frequency-domain markers(standing LF, sleeping HF), ABPM markers (ASBP%,ADBP%) and cardiovascular reflex test markers(heart rate variability with deep respiration, valsalva ratio).Standing LF, SqTv, SqTs and A SBP%were correlated with change of systolic BP from supine to standing(reflex test marker). all kinds of autonomic neuropathy markers were related to diabetes duration. Peripheral neuropathy and retinopathy have been associated with abnormal ratio of Ewing scores. HRV markers in normoalbuminuria group was lower significantly than that of healthy controls group , but no difference was observed between normoalbuminuria group and healthy controls group in cardiovascular reflex markers. UAER was correlated significantly with heart rate variability with deep respiration, valsalva ratio, change of systolic BP from supine to standing ,standing LF, sleeping HF, SqTv, SqTs, ASBP% and ADBP%. Conclusion The cardiac autonomic neuropathy is related to diabetes duration and other diabetic chronic complications, such as peripheral neuropathy retinopathy, UAER in diabetic patients.