title: Low heart rate variability is a risk factor for sudden cardiac death in type 2 diabetes.
abstract: The purpose of this study is to examine the association between sudden cardiac death (SCD) and heart rate variability (HRV) in subjects with and without type 2 diabetes and to determine whether low HRV can predict SCD in type 2 diabetes. Subjects were 8917 consecutively examined persons (3089 diabetic, and 5828 nondiabetic subjects) aged 35-69 years who underwent a 75 g oral glucose tolerance test (OGTT) together with electrocardiography (ECG). HRV was calculated from the 12-lead ECG as the coefficient of variance for 100 R-R intervals (CV(R-R)). During a median observation period of 5.2 years, SCD occurred in 56 subjects (33 diabetic, and 23 nondiabetic). Among diabetic subjects, mortality from SCD tended to be higher in subjects with a low CV(R-R) (P=0.004). After adjustment for age, gender, systolic blood pressure, total cholesterol (TC), triglycerides (TG), BMI, ischemic ECG change, and smoking history, relative risk (RR) of SCD was 2.07 (95% CI 1.02-4.17) in diabetic subjects with a CV(R-R) <2.2% compared with those with a CV(R-R) > or =2.2%. Diabetic subjects with a CV(R-R) <2.2% had significantly higher cumulative mortality from SCD than those with a CV(R-R) > or =2.2% (P=0.007). In type 2 diabetes, a low CV(R-R) carried an increased risk of SCD.
authors.affiliation: Hiroshima Atomic Bomb Casualty Council Health Management and Promotion Center, 3-8-6 Sendamachi, Naka-ku, Hiroshima 730-0052, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kataoka
authors.forename: Chikako
authors.initials: C
authors.lastname: Ito
authors.forename: Hideo
authors.initials: H
authors.lastname: Sasaki
authors.forename: Kiminori
authors.initials: K
authors.lastname: Yamane
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000401:mortality; D005260:Female; D005951:Glucose Tolerance Test; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors