Baroreflex sensitivity predicts cardiovascular events in patients with type 2 diabetes mellitus without structural heart disease.
BACKGROUND
Cardiovascular autonomic neuropathy is a major complication in patients with diabetes mellitus (DM). However, the relationship between cardiovascular autonomic neuropathy and the incidence of cardiovascular events has been poorly investigated in type 2 DM. The present study aimed to assess the long-term cardiovascular predictive value of baroreflex sensitivity (BRS) in Japanese patients with type 2 DM without structural heart disease.


RESULTS
BRS was evaluated using the phenylephrine method in 210 patients with type 2 DM who did not have structural heart disease or other severe complications. BRS was considered depressed if <6 ms/mmHg. Accurate follow-up information for 3-10 years (mean 4.7 years) was obtained in 184 patients (90 females, 94 males; mean age 58+/-12 years). The initial onset of a major adverse cardiovascular event (MACE) was investigated. During follow-up, 19 patients presented with a MACE (4 cardiovascular deaths, 3 nonfatal myocardial infarctions, 4 coronary revascularizations, 5 strokes, 2 congestive heart failures). Cox proportional hazards regression analysis revealed that depressed BRS was independently associated with the incidence of MACE (hazard ratio 1.93, 95% confidence interval 1.09-3.82, P=0.0236).


CONCLUSIONS
Depressed BRS at baseline has long-term cardiovascular predictive value in Japanese patients with type 2 DM without structural heart disease.
Okada
Norihiro
N
Department of Internal Medicine 1, Faculty of Medicine, Oita University, Oita, Japan.
Takahashi
Naohiko
N
Yufu
Kunio
K
Murozono
Yukichi
Y
Wakisaka
Osamu
O
Shinohara
Tetsuji
T
Anan
Futoshi
F
Nakagawa
Mikiko
M
Hara
Masahide
M
Saikawa
Tetsunori
T
Yoshimatsu
Hironobu
H
D000368:Aged; D017704:Baroreflex / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D010656:Phenylephrine; D011237:Predictive Value of Tests
D010656:Phenylephrine