Ang Lynn, Dillon Brendan, Mizokami-Stout Kara, Pop-Busui Rodica
Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, United States of America.
University of Michigan Medical School, Ann Arbor, MI, United States of America.
Auton Neurosci. 2020 May;225:102646. doi: 10.1016/j.autneu.2020.102646. Epub 2020 Feb 11.
Cardiovascular autonomic neuropathy (CAN) is a common and deadly complication of diabetes mellitus, which is frequently overlooked in clinical practice due to its characteristic subtle presentation earlier in disease. Yet, timely detection of CAN may help implementation of tailored interventions to prevent its progression and mitigate the risk of associated complications, including cardiovascular disease (CVD), cardiac arrhythmias, myocardial dysfunction leading to congestive heart failure and all-cause mortality. This review highlights current CAN epidemiology trends, novel mechanisms linking CAN with other diabetes complications and current recommendations for diagnosis and management of the disease in the clinical setting.
心血管自主神经病变(CAN)是糖尿病常见且致命的并发症,由于其在疾病早期具有特征性的隐匿表现,在临床实践中常被忽视。然而,及时检测CAN有助于实施针对性干预措施,以预防其进展并降低相关并发症的风险,包括心血管疾病(CVD)、心律失常、导致充血性心力衰竭的心肌功能障碍以及全因死亡率。本综述重点介绍了当前CAN的流行病学趋势、将CAN与其他糖尿病并发症联系起来的新机制以及临床环境中该疾病诊断和管理的当前建议。