title: Heart rate variability analysis: a useful assessment tool for diabetes associated cardiac dysfunction in rural and remote areas.
abstract: OBJECTIVE
  Cardiovascular complications are the main cause of death in people with diabetes. Early, asymptomatic changes are due to autonomic nervous system dysfunction, which if identified can lead to improved health. This study used detrended fluctuation analysis to identify changes in heart rate variability (HRV) associated with short-time electrocardiograph (ECG) recordings. The aim of the study was to determine whether heart rate variability analysis on short ECG recordings has the potential to be a useful adjunct to clinical practice.
  
  
  METHODS
  Comparative design with three independent simple random samples.
  
  
  METHODS
  University-based research project.
  
  
  METHODS
  Forty-eight people with no diabetes or cardiovascular complications had a 20 min ECG recorded, which was subsequently analysed using mathematical procedures. All participants also had a lying-to-standing autonomic nervous system test. Data was analysed using a Student t-test.
  
  
  RESULTS
  Heart rate variability expressed as a numeric value (alpha(1)), is reduced in disease states. We found a significant difference in alpha(1)(P = 0.03) between the ECG recordings of the diabetes and control groups. In addition lower alpha(1)values were obtained from people identified with autonomic dysfunction within the diabetes group.
  
  
  CONCLUSIONS
  The importance of our findings is that abnormal HRV identifies people with cardiovascular disease, irrespective of diabetes status, that may have autonomic neuropathy. HRV analysis is easily implemented by primary health care providers and has the potential to lead to improved health care by reducing inequity in rural areas and specifically addressing cardiovascular complications associated with diabetes.
authors.affiliation: School of Community Health, Charles Sturt University, Albury, Australia.
authors.forename: Allyson C
authors.initials: AC
authors.lastname: Flynn
authors.forename: Herbert F
authors.initials: HF
authors.lastname: Jelinek
authors.forename: Megan
authors.initials: M
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D018376:Cardiovascular Abnormalities / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009826:Old Age Assistance; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D019035:Rural Health Services