DIAGNOSTIC VALUE OF SPECTRAL ANALYSIS OF HEART RATE VARIABILITY IN CARDIAC AUTONOMIC NEUROPATHY AND TYPE 2 DIABETES MELLITUS

Abstract

Aim. To assess the value of spectral parameters of heart rate variability (HRV) in the diagnostics of cardiac autonomic neuropathy (CAN) among patients with Type 2 diabetes mellitus (DM‑2), according to the presence or absence of metabolic syndrome (MS). Material and methods. The spectral analysis of 5‑minute HRV records was performed in 157 DM‑2 patients. MS was diagnosed according to WHO criteria, while the diagnosis of CAN was based on two or more abnormal Ewing tests (deep breathing test, Valsalva test, and orthostatic test with blood pressure and heart rate assessment). Area under the receiver operating curve (AUROC) values were calculated to assess TP (total power) and HF (high frequency) components of HRV. Results. The prevalence of CAN was 57,6% and 87,1% in patients with or without MS, respectively. Among MS-free patients, AUROC values for TP and HF parameters (0,84 and 0,90) were significantly higher than respective values in participants with MS (0,78 and 0,89). AUROC analysis identified the cut-off points for CAN diagnosis, taking into account the presence or absence of MS. Operational characteristics of TP and HF parameters were slightly lower in MS patients. Conclusion. The assessment of spectral HRV parameters is a highly informative test for CAN diagnostics. Cut-off points and operational characteristics of HRV parameters differ in patients with or without MS.

Keywords

• heart rate variability
• diabetes mellitus
• cardiac autonomic neuropathy
• diagnostics