Prospective investigation of autonomic cardiac neuropathy in diabetes mellitus

Clin Auton Res. 2002 Oct;12(5):373-8. doi: 10.1007/s10286-002-0046-6.

Abstract

Forty-five patients with clinically manifest diabetes mellitus were investigated (25 male, 20 female, 48 +/- 10 yrs, 14 diabetes type 1, 31 type 2). Duration of manifestation was 12.2 +/- 9.7 yrs.Vibration thresholds and thermal thresholds were assessed. Respiratory sinus arrhythmia (RSA) was measured during deep respiration at 6/min. The QTc-interval was assessed according to Bazett's formula. MIBG-SPECT was carried out in all 45 cases. Patients with abnormal MIBI perfusion scintigraphy had previously been excluded from the study. RSA was abnormal in 12/45 patients. The MIBG-SPECT was abnormal in 28/45 cases with dorso-septal lack of activity. No difference was seen between type 1 and 2 diabetics with regard to either vibration and thermal thresholds or RSA and MIBG-SPECT. Abnormal MIBG-SPECT was correlated with vibration threshold and abnormal heart RSA tests but not with abnormality in QTc. The mean QTc-interval was 419 +/- 24 ms (QTc normal in 36, abnormal > or = 440ms in 9). It was longer in female than in male patients. There exists no significant correlation of QTc-interval results with either heart rate variability or MIBG-SPECT. The QTc-interval is not a sensitive parameter of autonomic cardiac denervation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 3-Iodobenzylguanidine
  • Adult
  • Arrhythmia, Sinus / etiology
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / diagnostic imaging
  • Diabetic Neuropathies / physiopathology*
  • Electrocardiography
  • Female
  • Heart / innervation*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiopharmaceuticals
  • Respiration
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine