Heart rate fragmentation is impaired in type 2 diabetes mellitus patients

Gabriela Aguiar Mesquita Galdino; Luiz Eduardo Virgilio Silva; Silvia Cristina Garcia Moura-Tonello; Juliana Cristina Milan-Mattos; Stephanie Nogueira Linares; Alberto Porta; Thaís Marques da Silva; Rubens Fazan Jr; Thomas Beltrame; Aparecida Maria Catai

doi:10.1016/j.diabres.2022.110223

Heart rate fragmentation is impaired in type 2 diabetes mellitus patients

Diabetes Res Clin Pract. 2023 Feb:196:110223. doi: 10.1016/j.diabres.2022.110223. Epub 2022 Dec 16.

Affiliations

¹ Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
² Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil; Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.
³ Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
⁴ Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
⁵ Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Samsung R&D Institute Brazil - SRBR, Campinas, São Paulo, Brazil.
⁶ Cardiovascular Physical Therapy Laboratory, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil. Electronic address: mcatai@ufscar.br.

PMID: 36529300
DOI: 10.1016/j.diabres.2022.110223

Abstract

Aims: To evaluate the heart rate fragmentation (HRF) of type 2 diabetes mellitus (T2DM) patients and its relationship with heart rate variability (HRV) indices.

Methods: One hundred sixty-four men, aged 47-57 years were retrospectively analyzed from a database. Participants were T2DM (n = 82) and apparently healthy (n = 82). R-R interval time series recorded by electrocardiogram were collected at the supine position for 10 to 15 min. From HRF, the percentage of inflection points (PIP), percentage of words with zero, one, two, or three inflections points (W₀, W₁, W₂, W₃), and percentage with only type hard, soft, or mixed inflections points type (W^H, W^S, W^M) were quantified.

Results: T2DM presented higher PIP, W^S, W^M and W₃, while W^H and W₁ was lower compared with healthy (p < 0.05). Moreover, a positive moderate correlation was found between W^H and root mean square of the successive R-R differences (RMSSD) and high frequency (HF) indices. In contrast, a negative moderate correlation was found between W^S and W^M with RMSSD and HF indices.

Conclusions: T2DM have increased fragmentation patterns, and words grouped by inflection type are more closely related to HRV. The HRF approach might be useful to assess heart rate dynamic abnormalities in males with type 2 diabetes.

Keywords: Autonomic nervous system; Heart rate fragmentation; Heart rate variability; Symbolic dynamic; Type 2 diabetes mellitus.

MeSH terms

Diabetes Mellitus, Type 2*
Electrocardiography
Heart Rate / physiology
Humans
Male
Retrospective Studies