Cardiovascular Variability Analysis and Baroreflex Estimation in Patients with Type 2 Diabetes in Absence of Any Manifest Neuropathy

Autor(es)

Garcia de Moura-Tonello, Silvia Cristina ^[1] ; Porta, Alberto ^{[2, 3]} ; Marchi, Andrea ^[4] ; Fagundes, Alessandra de Almeida ^[1] ; Francisco, Cristina de Oliveira ^[1] ; Rehder-Santos, Patricia ^[1] ; Milan-Mattos, Juliana Cristina ^[1] ; Simoes, Rodrigo Polaquini ^[1] ; Gois, Mariana de Oliveira ^[1] ; Catai, Aparecida Maria ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Carlos, Dept Phys Therapy, BR-13560 Sao Carlos - Brazil

^[2] IRCCS Policlin San Donato, Dept Cardiothorac Vasc Anesthesia & Intens Care, Milan - Italy

^[3] Univ Milan, Dept Biomed Sci Hlth, Milan - Italy

^[4] Politecn Milan, Dept Elect Informat & Bioengn, I-20133 Milan - Italy

• Tipo de documento: Artigo Científico
• Fonte: PLoS One; v. 11, n. 3 MAR 17 2016.
• Citações Web of Science: 11

Resumo

Introduction Indexes derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) fluctuations can detect autonomic dysfunction in individuals with type 2 diabetes mellitus (DM) associated to cardiovascular autonomic neuropathy (CAN) or other neuropathies. It is unknown whether HP and SAP variability indexes are sensitive enough to detect the autonomic dysfunction in DM patients without CAN and other neuropathies. Methods We evaluated 68 males aged between 40 and 65 years. The group was composed by DM type 2 DM with no manifest neuropathy (n = 34) and healthy (H) subjects (n = 34). The protocol consisted of 15 minutes of recording of HP and SAP variabilities at rest in supine position (REST) and after active standing (STAND). The HP power in the high frequency band (HF, from 0.15 to 0.5 Hz), the SAP power in the low frequency band (LF, from 0.04 to 0.15 Hz) and BRS estimated via spectral approach and sequence method were computed. Results The HF power of HP was lower in DM patients than in H subjects, while the two groups exhibited comparable HF power of HP during STAND. The LF power of SAP was similar in DM and H groups at REST and increased during STAND in both groups. BRSs estimated in the HF band and via baroreflex sequence method were lower in DM than in H and they decreased further during STAND in both populations. Conclusion Results suggest that vagal control of heart rate and cardiac baroreflex control was impaired in type 2 DM, while sympathetic control directed to vessels, sympathetic and baroreflex response to STAND were preserved. Cardiovascular variability indexes are sensitive enough to typify the early, peculiar signs of autonomic dysfunction in type-2 DM patients well before CAN becomes manifest. (AU)

• Processo FAPESP: 13/07953-3 - Avaliação do efeito agudo da fototerapia por meio de diodos emissores de luz (LEDs) na cinética do consumo de oxigênio muscular e pulmonar em pacientes com diabetes mellitus
• Beneficiário: Aparecida Maria Catai
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 10/52070-4 - Novas técnicas para avaliação das alterações das oscilações cardiovasculares com o envelhecimento
• Beneficiário: Aparecida Maria Catai
• Modalidade de apoio: Auxílio à Pesquisa - Regular