Silent myocardial ischemia and cardiac autonomic neuropathy in diabetics.
OBJECTIVE
To evaluate the association of silent myocardial ischemia (SMI) with cardiac autonomic neuropathy in asymptomatic diabetic patients.


METHODS
Two hundred asymptomatic patients of diabetes mellitus were assessed for evidence of cardiac autonomic neuropathy. Of these, 30 (15 males, 15 females; mean age 44.7 +/- 8.8 years) were found to have cardiac autonomic neuropathy. Thirty (30) age and sex matched diabetic patients (mean age 42.4 +/- 7.6 years) who had no evidence autonomic neuropathy were included in the study as control group. Both the groups of patients were evaluated for SMI by 24 hour ambulatory electrocardiographic (ECG) monitoring.


RESULTS
Incidence of SMI was significantly higher in patients with autonomic neuropathy 12/30 (40%) compared to those without 3/30 (10%) p < 0.001. Duration of diabetes was more (13 +/- 1.59 years) in patients with autonomic neuropathy compared to the control group (8.66 +/- 1.55 years) p < 0.001. Serum cholesterol and triglyceride levels were significantly higher in patients with autonomic neuropathy in comparison to control group < 0.05 and < 0.01, respectively. There was no difference in the pattern of SMI in the two groups (p = N.S).


CONCLUSIONS
Cardiac autonomic neuropathy predisposes patients with diabetes mellitus to SMI. Twenty four hour ambulatory ECG monitoring provides useful diagnostic information in early detection and evaluation of SMI in asymptomatic diabetic patients.
Jalal
S
S
Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar.
Alai
M S
MS
Khan
K A
KA
Jan
V M
VM
Rather
H A
HA
Iqbal
K
K
Tramboo
N A
NA
Lone
N A
NA
Dar
M A
MA
Hayat
A
A
Abbas
S M
SM
D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006321:Heart / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D012307:Risk Factors