Endocrine Abstracts

Purpose: The goal of the study was to determine: existence and degree of diabetic cardiovascular autonomic neuropathy (DCAN) depending on the type of diabetes; influence on systolic and diastolic function of myocardium and correlation with coronary disease and cardiovascular risk factors; possibility of early detection and diagnostic value of cardiovascular tests (CVT).

Methods: The study involved 90 participants: 30 patients with type 1 diabetes (T1DM), 30 patients with type 2 diabetes (T2DM) and 30 participants in the control group. Electrocardiogram, cardiac stress test and echocardiography has been done to all participants. Function of the autonomic nervous system was evaluated using 5 CVT: Valsalve maneuver, deep breathing, stand-up after lying position, orthostatic hypotension and Hand grip tests.

Results: The results showed that DCAN occurred significantly more often in patients with T2DM (P<0.001). In patients with T1DM and T2DM with DCAN cardiac stress test was positive significantly more often (P<0.05), i.e. correlation with coronary disease. Concerning coronary disease risk factors most common correlation was found with obesity and hypertension. Diastolic function of the left ventricle was significantly often impaired in patients with DCAN (P<0.001), especially in T2DM. The most common pathological CVT in T1DM (71,4%), T2DM (83,3%) P<0.001, was standup from lying position test.

Conclusion: Significant correlation between impaired diastolic function of the left ventricle and abnormal cardiac stress test results with DCAN indicates its significance in etiopathogenesis of diabetic cardiomyopathy and coronary disease. CVTs enable early detection of DCAN and objective cardiovascular evaluation.