Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, South Korea.
Department of Preventive Medicine, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, South Korea.
Somatosens Mot Res. 2020 Sep;37(3):149-156. doi: 10.1080/08990220.2020.1756245. Epub 2020 Apr 23.
Cardiac autonomic neuropathy (CAN) is a common and important chronic complication in diabetic patients. Heart failure resulting from cardiomyopathy is also a lethal complication in diabetic patients. However, data showing the exact association between CAN and heart failure in diabetic patients are relatively scarce. Therefore, our study aimed to determine the association between the parameters assessing CAN and heart function in diabetic patients. The medical records of type 2 diabetic patients who underwent an autonomic function test with heart rate variability (HRV) and echocardiography were reviewed from January 2018 to December 2018. A total of 100 type 2 diabetic patients were included, and the association between the parameters assessing CAN and heart function was analysed. Among the 100 analysed patients, 65 were diagnosed with CAN and 26 showed diastolic dysfunction. Moreover, 19 (73.1%) diabetic patients with diastolic dysfunction were complicated with CAN. The occurrence of diastolic dysfunction was higher in diabetic patients with CAN than in diabetic patients without CAN (29.2% vs 20.0%, ), and the occurrence of CAN was higher in diabetic patients with diastolic dysfunction than in patients without diastolic dysfunction (73.1% vs 62.2%, ). However, there were no significant associations between HRV parameters and heart function. We demonstrated that diastolic dysfunction is more common in diabetic patients complicated with CAN than in diabetic patients without CAN, although several diabetic patients without diastolic dysfunction are also diagnosed with CAN. Moreover, further studies about the long-term serial monitoring of heart function according to the progression of CAN are required to confirm the exact association between CAN and heart function.
心脏自主神经病变（CAN）是糖尿病患者常见且重要的慢性并发症。由心肌病引起的心力衰竭也是糖尿病患者的致命并发症。然而，关于 CAN 与糖尿病患者心力衰竭之间的确切关联的数据相对较少。因此，我们的研究旨在确定评估 CAN 的参数与糖尿病患者心功能之间的关系。我们回顾了 2018 年 1 月至 2018 年 12 月间接受心率变异性（HRV）和超声心动图自主神经功能测试的 2 型糖尿病患者的病历。共纳入 100 例 2 型糖尿病患者，并分析了评估 CAN 和心功能的参数之间的关系。在 100 例分析患者中，65 例被诊断为 CAN，26 例存在舒张功能障碍。此外，19 例（73.1%）存在舒张功能障碍的糖尿病患者并发 CAN。与无 CAN 的糖尿病患者相比，有 CAN 的糖尿病患者舒张功能障碍的发生率更高（29.2%比 20.0%，），而有舒张功能障碍的糖尿病患者中 CAN 的发生率更高（73.1%比 62.2%，）。然而，HRV 参数与心功能之间没有显著相关性。我们的研究表明，与无 CAN 的糖尿病患者相比，并发 CAN 的糖尿病患者舒张功能障碍更为常见，尽管一些无舒张功能障碍的糖尿病患者也被诊断为 CAN。此外，需要进一步研究根据 CAN 的进展对心功能进行长期的连续监测，以确认 CAN 与心功能之间的确切关联。
