Document Detail


Cardiovascular autonomic neuropathy and subclinical cardiovascular disease in normoalbuminuric type 1 diabetic patients.
MedLine Citation:
PMID:  22498696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular autonomic neuropathy (CAN) is associated with increased mortality in diabetes. Since CAN often develops in parallel with diabetic nephropathy as a confounder, we aimed to investigate the isolated impact of CAN on cardiovascular disease in normoalbuminuric patients. Fifty-six normoalbuminuric, type 1 diabetic patients were divided into 26 with (+) and 30 without (-) CAN according to tests of their autonomic nerve function. Coronary artery plaque burden and coronary artery calcium score (CACS) were evaluated using computed tomography. Left ventricular function was evaluated using echocardiography. Blood pressure and electrocardiography were recorded through 24 h to evaluate nocturnal drop in blood pressure (dipping) and pulse pressure. In patients +CAN compared with -CAN, the CACS was higher, and only patients +CAN had a CACS >400. A trend toward a higher prevalence of coronary plaques and flow-limiting stenosis in patients +CAN was nonsignificant. In patients +CAN, left ventricular function was decreased in both diastole and systole, nondipping was more prevalent, and pulse pressure was increased compared with -CAN. In multivariable analysis, CAN was independently associated with increased CACS, subclinical left ventricular dysfunction, and increased pulse pressure. In conclusion, CAN in normoalbuminuric type 1 diabetic patients is associated with distinct signs of subclinical cardiovascular disease.
Authors:
Ulrik Madvig Mogensen; Tonny Jensen; Lars Køber; Henning Kelbæk; Anne Sophie Mathiesen; Ulrik Dixen; Peter Rossing; Jannik Hilsted; Klaus Fuglsang Kofoed
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-12
Journal Detail:
Title:  Diabetes     Volume:  61     ISSN:  1939-327X     ISO Abbreviation:  Diabetes     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-22     Completed Date:  2012-09-10     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0372763     Medline TA:  Diabetes     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1822-30     Citation Subset:  AIM; IM    
Affiliation:
The Heart Centre, Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. ulrik_mogensen@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Autonomic Nervous System / physiopathology*,  ultrasonography
Cardiovascular Diseases / physiopathology*,  ultrasonography
Cardiovascular System / innervation,  physiopathology*,  ultrasonography
Coronary Artery Disease / physiopathology,  ultrasonography
Coronary Vessels / physiopathology,  ultrasonography
Diabetes Mellitus, Type 1 / complications,  physiopathology*,  ultrasonography
Diabetic Neuropathies / physiopathology*,  ultrasonography
Female
Hemoglobin A, Glycosylated / analysis
Humans
Hypertension / physiopathology,  ultrasonography
Male
Middle Aged
Tomography, X-Ray Computed
Ventricular Dysfunction, Left / physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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