Endocrine Abstracts

Introduction: Cardiovascular autonomic neuropathy (CAN) is a significant risk factor for cardiovascular morbidity and mortality in patients with diabetes mellitus. However, an association between CAN and severity of coronary atherosclerosis in patients with ischemic heart disease (IHD) was not investigated.

Objectives: The aim of this study was to investigate the relationship of CAN and coronary stenosis in patients with clinical signs of IHD.

Materials and methods: We examined 63 patients, 48 men and 15 women with clinical symptoms of IHD (aged 61.79±1.18 years, BMI – 30.39±0.61 kg/m²) (data are presented everywhere as mean±SEM). All patients were performed coronaroventriculography, oral glucose tolerance test and 5 standart tests to diagnose CAN by Ewing. The diagnosis of CAN was confirmed in patients with 3 positive tests. The data analysis by SPSS statistical package version 23.0 for Windows.

Results: CAN was diagnosed in 52.4% patients, diabetes mellitus type 2 was diagnosed in 17.5% patients. All patients were divided for 3 groups depending on the number of occluded coronary arteries – with lesions in 1, 2 or 3 arteries. We found positive correlation between the number of the coronary arteries with atherosclerotic lesions and impaired results of Valsalva maneuver reflecting parasympathetic dysfunction (OR=–0.27, P<0.05) and with the changes of diastolic blood pressure to isometric exercise (handgrip test) reflecting sympathetic dysfunction (OR=–0.44, P<0.05).

Conclusion: We found some relationship between the severity of coronary arteries stenosis and sympathetic and parasympathetic dysfunction in patients with IHD with and without diabetes mellitus. These data can suggest the pathogenetic role of the impairment of cardiovascular autonomic regulation in the progression of atherosclerosis of coronary arteries.