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Association Between Cardiovascular Autonomic Neuropathy and Left Ventricular Dysfunction
- Source :
- Journal of the American College of Cardiology. 61:447-454
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Objectives The goal of these studies was to determine the association between cardiovascular autonomic neuropathy (CAN) and indices of left ventricle (LV) structure and function in patients with type 1 diabetes (T1DM) in the DCCT/EDIC (Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications) study. Background The pathophysiology of LV dysfunction in T1DM remains unclear, especially when the LV ejection fraction (EF) is preserved. Whether CAN is associated with LV dysfunction is unclear. Methods Indices of LV structure and function were obtained by cardiac magnetic resonance imaging (CMRI). CAN was assessed by cardiovascular reflex testing (R-R response to paced breathing, Valsalva ratio, and blood pressure response to standing). Analyses were performed in 966 DCCT/EDIC participants with valid CMRI and CAN data (mean age 51 years, 52% men, mean diabetes duration 29 years, and mean glycosylated hemoglobin 7.9%). Results Systolic function (EF, end-systolic and end-diastolic volumes, stroke volumes) was not different in 371 subjects with CAN compared with 595 subjects without CAN. In multiple-adjusted analyses, participants with either abnormal R-R variation or a composite of abnormal R-R variation, abnormal Valsalva ratio, and postural blood pressure changes had significantly higher LV mass, mass-to-volume-ratio, and cardiac output compared with those with normal tests (p Conclusions In this large cohort of patients with T1DM, CAN is associated with increased LV mass and concentric remodeling as assessed by CMRI independent of age, sex, and other factors. (Diabetes Control and Complications Trial [DCCT]; NCT00360815 ) (Epidemiology of Diabetes Interventions and Complications [EDIC]; NCT00360893 )
- Subjects :
- Type 1 diabetes
medicine.medical_specialty
Cardiac output
Ejection fraction
endocrine system diseases
medicine.diagnostic_test
business.industry
medicine.disease
Blood pressure
Cardiac magnetic resonance imaging
Diabetes mellitus
Internal medicine
Cardiology
Medicine
Cardiology and Cardiovascular Medicine
business
Ventricular remodeling
Stroke
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 61
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....9839e6ed88a45e2e5b5cd3f142dfa961