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Inspiratory muscle weakness is associated with autonomic cardiovascular dysfunction in patients with type 2 diabetes mellitus

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Abstract

Introduction

Diabetic autonomic neuropathy is a complication of diabetes mellitus (DM) that can cause cardiovascular and respiratory abnormalities. The association between respiratory muscle weakness and autonomic cardiovascular neuropathy has not yet been studied. The aims of the present study were to assess respiratory muscle strength, pulmonary function, and heart rate (HR) variability in diabetic patients with and without diabetic autonomic neuropathy.

Materials and methods

Twenty-four patients with type 2 DM were divided into two groups: those without diabetic autonomic neuropathy (C group, n = 12); and those with diabetic autonomic neuropathy (DAN group, n = 12). We evaluated pulmonary function, maximum static inspiratory pressure (PImax), maximum static expiratory pressure (PEmax), and HR variability.

Results

The results of the pulmonary function tests were similar in both the groups. PImax was lower in the DAN group (80 ± 24 vs. 102 ± 24 cmH2O, p = 0.03), but PEmax was similar in both the groups. RR intervals (878 ± 122 vs. 743 ± 88 ms; p < 0.01), standard deviation of RR intervals (28 ± 11 vs. 14 ± 4 ms; p < 0.01) and squared root of the sum of successive differences of squared RR intervals (15 ± 6 vs. 8 ± 5 ms; p < 0.01) were higher in the C group. In the DAN group, resting HR was higher (82 ± 10 vs. 69 ± 9 bpm; p = 0.01) than in the C group. There was a positive correlation between PImax and RR intervals (r = 0.452, p = 0.02) and a negative correlation between PImax and resting HR (r = −0.482, p = 0.01), and PImax and DM duration (r = −0.463, p = 0.02).

Conclusion

Patients with type 2 DM and autonomic neuropathy showed reduced respiratory muscle strength and less HR variability. Respiratory muscle weakness may be associated with autonomic dysfunction in these patients.

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Authors and Affiliations

  1. Graduate Program in Health Sciences/Cardiology, Heart Institute, Fundação Universitária de Cardiologia do Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil

    Diogo Machado Kaminski, Beatriz D’Agord Schaan & Rodrigo Della Méa Plentz

  2. Division of Endocrinology, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Beatriz D’Agord Schaan

  3. Department of Physical Therapy and Rehabilitation, Universidade Federal de Santa Maria, Santa Maria, Brazil

    Antônio Marcos Vargas da Silva

  4. Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil

    Pedro Paulo Soares

  5. Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite, 245/308, Porto Alegre, RS, CEP: 90050-170, Brazil

    Rodrigo Della Méa Plentz & Pedro Dall’Ago

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  1. Diogo Machado Kaminski
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  2. Beatriz D’Agord Schaan
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  6. Pedro Dall’Ago
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Correspondence to Pedro Dall’Ago.

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Kaminski, D.M., D’Agord Schaan, B., da Silva, A.M.V. et al. Inspiratory muscle weakness is associated with autonomic cardiovascular dysfunction in patients with type 2 diabetes mellitus. Clin Auton Res 21, 29–35 (2011). https://doi.org/10.1007/s10286-010-0087-1

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  • DOI: https://doi.org/10.1007/s10286-010-0087-1

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