Time- and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d5006064e170">Aims:</h5> <p id="P3">To evaluate the association between impaired heart rate variability (HRV) and cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM). </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d5006064e175">Methods:</h5> <p id="P4">A total of 655 patients with T2DM who underwent cardiovascular autonomic function testing were consecutively recruited and followed up prospectively. Time- and frequency-domain HRV were assessed for 5 minutes by beat-to-beat heart rate recording. We estimated the development of CVD events during a follow-up period. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d5006064e180">Results:</h5> <p id="P5">During a median follow-up of 7.8 years, 9.6% (n=49) of patients developed CVD (10.6 per 1,000 patient-years). The mean age and diabetes duration were 54.9 ± 8.6 years and 9.4 ± 7.3 years, respectively. Patients who had cardiovascular autonomic neuropathy (CAN) had decreased HRV compared with those with normal autonomic function. Multivariable cox hazard regression analysis revealed the lowest 10 ^th percentile of the SD of the normal-to-normal interval (HR 2.62; 95% CI 1.30–5.31), total power (HR 2.81; 95% CI 1.37–5.79), low-frequency power (HR 2.68; 95% CI 1.28–5.59), and high-frequency power (HR 2.24; 95% CI 1.09–4.59) were significant predictors for developing CVD in patients with T2DM. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d5006064e188">Conclusions:</h5> <p id="P6">Time- and frequency-domain measures of HRV independently predicted cardiovascular outcome in patients with T2DM. </p> </div>