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Decreased heart rate variability may predict the progression of carotid atherosclerosis in type 2 diabetes

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Abstract

Heart rate variability (HRV), a measure of autonomic function, can predict survival outcomes. Cardiovascular disease is a known complication of diabetes, and we aimed to determine if autonomic dysfunction was associated with carotid artery atherosclerotic plaques in type 2 diabetic patients. We assessed frequency domain HRV from power spectral analysis of 24 h Holter ECG recordings, expiration/inspiration (E/I) ratio during deep breathing, acceleration index (AI) of R–R interval in response to head-up tilt, and the degree of carotid artery atherosclerosis in 61 type-2 diabetic patients (39 males, 45–69 years). Studies were carried out 5–6 years after diagnosis (baseline) and repeated 8 years after diagnosis (follow-up). At baseline, patients diagnosed with autonomic neuropathy, with abnormal E/I ratio and abnormal AI measurements, had decreased low frequency (LF) HRV. Baseline E/I ratio correlated with day (r = 0.34; P < 0.001) and night-time (r = 0.44; P < 0.001) LF power. Night-time HRV did not differ in patient with and without autonomic neuropathy. Reduced common carotid artery diameter and atherosclerotic intima-media thickness (IMT) both correlated with HRV at baseline. At follow-up, all HRV variables decreased significantly. Furthermore, patients with lower LF power at baseline, had a larger increase in the thickness of the carotid bulb intima-media at follow-up. Our results show that LF HRV power is associated with the extent and progression of carotid atherosclerosis in type 2 diabetes. A low LF HRV may predict the progression of atherosclerosis in these patients.

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Acknowledgments

We thank Mrs. Helene Brandt, Ulrika Gustavsson, Ann Radelius, Christina Rosborn, Gerd Östling, and Birgitta Frid for skilful technical assistance. This study was supported by grants from the Swedish Diabetes Association, the Swedish Medical Research Council, the Ernhold Lundström Foundation, Research Funds of Malmö University Hospital, Swedish Heart-Lung Foundation, Research Funds at University Hospital MAS, the Albert Påhlsson Foundation, Hulda Ahlmroth Foundation, NW Lundblad Foundation, and the Swedish Life Assurances Fund.

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Authors and Affiliations

  1. Dept. of Vascular Diseases, University of Lund, University Hospital UMAS, S-205 02, Malmö, Sweden

    Anders Gottsäter

  2. Dept. of Clinical Physiology, University of Lund, University Hospital UMAS, Malmö, Sweden

    Åsa Rydén Ahlgren

  3. Dept. of Medicine, University of Lund, University Hospital UMAS, Malmö, Sweden

    Soumia Taimour

  4. Dept. of Endocrinology, University of Lund, University Hospital UMAS, Malmö, Sweden

    Göran Sundkvist

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  1. Anders Gottsäter
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  2. Åsa Rydén Ahlgren
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  4. Göran Sundkvist
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Correspondence to Anders Gottsäter.

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Gottsäter, A., Ahlgren, Å.R., Taimour, S. et al. Decreased heart rate variability may predict the progression of carotid atherosclerosis in type 2 diabetes. Clin Auton Res 16, 228–234 (2006). https://doi.org/10.1007/s10286-006-0345-4

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