Prospective investigation of autonomic cardiac neuropathy in diabetes mellitus.
Forty-five patients with clinically manifest diabetes mellitus were investigated (25 male, 20 female, 48 +/- 10 yrs, 14 diabetes type 1, 31 type 2). Duration of manifestation was 12.2 +/- 9.7 yrs.Vibration thresholds and thermal thresholds were assessed. Respiratory sinus arrhythmia (RSA) was measured during deep respiration at 6/min. The QTc-interval was assessed according to Bazett's formula. MIBG-SPECT was carried out in all 45 cases. Patients with abnormal MIBI perfusion scintigraphy had previously been excluded from the study. RSA was abnormal in 12/45 patients. The MIBG-SPECT was abnormal in 28/45 cases with dorso-septal lack of activity. No difference was seen between type 1 and 2 diabetics with regard to either vibration and thermal thresholds or RSA and MIBG-SPECT. Abnormal MIBG-SPECT was correlated with vibration threshold and abnormal heart RSA tests but not with abnormality in QTc. The mean QTc-interval was 419 +/- 24 ms (QTc normal in 36, abnormal > or = 440ms in 9). It was longer in female than in male patients. There exists no significant correlation of QTc-interval results with either heart rate variability or MIBG-SPECT. The QTc-interval is not a sensitive parameter of autonomic cardiac denervation.
Claus
D
D
Dept. of Neurology, Hospital Darmstadt, Teaching Hospital of the Universities of Frankfurt and Heidelberg, Heidelberger Landstrasse 379, 64297 Darmstadt, Germany.
Meudt
O
O
Rozeik
C
C
Engelmann-Kempe
K
K
Huppert
P E
PE
Wietholtz
H
H
D019797:3-Iodobenzylguanidine; D000328:Adult; D001146:Arrhythmia, Sinus / Q000209:etiology; D003929:Diabetic Neuropathies / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012119:Respiration; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine