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ECPB 2018, 83(3): 24–28
https://doi.org/10.25040/ecpb2018.03.024
Research articles

Specific Aspects of Heart Rate Variability Parameters Depending on the Presence of Arterial Hypertension in Patients with Type 2 Diabetes Mellitus

A.M. URBANOVYCH1, O.V. SAFONOVA1, M.O. URBANOVYCH1, I.O. KOSTITSKA2
Abstract

Introduction. The primary reason for early disablement and mortality in patients with type 2 diabetes mellitus (DM) are cardiovascular diseases (CVD), in the development of which arterial hypertension (AH) plays the main role which, according to the national statistic data, is being reported in 80 % of type 2 diabetes patients.

In clinical trials it has been noted, that in patients with type 2 DM first, preclinical signs of cardial pathology are the abnormalities of cardial vegetative regulation. Parameters of heart rate variability may be used as well as prognostic criteria of unfavorable effects in patients with type 2 DM.

Hence, the purpose of this study was to analyze the heart rate variability (HRV) in patients with type 2 DM without CVD and with I-II grade of AH.

Materials and methods. After the diagnosis verification and informed consent signing 175 patients with type 2 DM with I-II grade of AH and without AH and coronary artery disease (CAD) participated in the study. Patients with type 2 DM were divided into two groups: the 1st group - without AH and CAD (77 patients) and the 2nd - with I-II grade of AH (98 patients). Antropometrical, laboratory and instrumental assessments were performed for all patients. 24-hour Holter monitoring (HM) of ECG with the analysis of main indicies of HRV was carried by using the hardware-controlled complex model 3225 "DiaCard" manufactured by "Solvaig" (Ukraine).

Results. Consequently, statistically reliable depression of HRV in type 2 DM patients with AH was discovered by the effect of both diminishment of the time indications with short and long cycle duration (SDNN and SDANN), SDNNi (SD of NN intervals for all 5-minute intervals, represents sympathetic-parasympathetic modulation), and spectral indexes, LF in particular, as compared with the group of patients with DM type 2 without CVD.

The decrease of low frequence of LF-component capacity of HR (represents sympatheticparasympathetic baroreflex modulation) indicates the decline of baroreflex sensitivity which can lead to abnormalities of baroreflex regulation of hemodynamics.

Furthermore, in the group of patients with 2 DM type with AH the decline of spectral components HF anf LF capacity was discovered when the equilibration between them stays constant, which allows to speak about the reduction of both sympathetic and parasympathetic parts of vegetative nervous system in this group of patients.

Conclusions. The depression of HRV has been noticed in patients with 2 DM type with AH as a result of the decrease of both time and spectral indexes which significantly affects the prognosis. Consequently, patients with 2 DM type were recommended to perform HM ECG regularly with the analysis of HRV indices, the results of which have to be considered during the medical and preventive arrangements.

Article recieved: 29.08.2018

Keywords: diabetes mellitus type 2, arterial hypertension, holter monitor ECG, heart rate variability

Full text: PDF (Ukr) 237K


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