Diabetic cardiac autonomic dysfunction: parasympathetic versus sympathetic
Diabetic cardiac autonomic dysfunction: parasympathetic versus sympathetic
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DOI：
10.1007/bf03164884
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发表时间：
1999-04-01
影响因子：
2.6
通讯作者：
Shouda, S
中科院分区：
文献类型：
--
作者：
Uehara, A;Kurata, C;Shouda, S
糖尿病性心脏自主神经功能紊乱常引起致死性心律失常和心源性猝死。I-123-间碘苄胍（MIBG）可评价心脏交感神经功能障碍，心率变异性（HRV）分析可反映心脏副交感神经活动。我们研究是否心脏副交感神经功能障碍评估HRV可能与交感神经功能障碍评估MIBG在糖尿病patients.Methods和Results：在24小时心电图，我们分析了4个HRV参数：高频功率（HF），HF在清晨（EMHF），rMSSD和pNN 50。注射后15分钟（早期）和150分钟（晚期）获得MIBG平面图像和SPECT，并计算心脏洗脱率。9个左心室区域的缺损评分采用4分制（0 =正常，类似于3 =严重缺损）。在20例无充血性心力衰竭、冠状动脉疾病和肾功能衰竭的糖尿病患者中，副交感神经HRV参数与晚期图像中的缺陷评分（DS）之和呈负相关部分参数与洗脱率呈负相关（R =-0.50与-0.55，p < 0.05）。在64例糖尿病患者中，这些参数与晚期DS（R = -0.28，p = 0.35，p = 0.05）和早期DS（R = -0.27，p = 0.32，p = 0.05）呈负相关。
Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. I-123-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients.Methods and Results: In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0 = normal similar to 3 = severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R = -0.47 similar to -0.59, p < 0.05) and some parameters had a negative correlation with the washout rate (R = -0.50 similar to -0.55, p < 0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R = -0.28 similar to -0.35, p < 0.05) and early DS (R = -0.27 similar to -0.32, p < 0.05).Conclusions: The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one.