title: Nonlinear methods to assess changes in heart rate variability in type 2 diabetic patients.
abstract: BACKGROUND
  Heart rate variability (HRV) is an important indicator of autonomic modulation of cardiovascular function. Diabetes can alter cardiac autonomic modulation by damaging afferent inputs, thereby increasing the risk of cardiovascular disease. We applied nonlinear analytical methods to identify parameters associated with HRV that are indicative of changes in autonomic modulation of heart function in diabetic patients.
  
  
  OBJECTIVE
  We analyzed differences in HRV patterns between diabetic and age-matched healthy control subjects using nonlinear methods.
  
  
  METHODS
  Lagged Poincaré plot, autocorrelation, and detrended fluctuation analysis were applied to analyze HRV in electrocardiography (ECG) recordings.
  
  
  RESULTS
  Lagged Poincare plot analysis revealed significant changes in some parameters, suggestive of decreased parasympathetic modulation. The detrended fluctuation exponent derived from long-term fitting was higher than the short-term one in the diabetic population, which was also consistent with decreased parasympathetic input. The autocorrelation function of the deviation of inter-beat intervals exhibited a highly correlated pattern in the diabetic group compared with the control group.
  
  
  CONCLUSIONS
  The HRV pattern significantly differs between diabetic patients and healthy subjects. All three statistical methods employed in the study may prove useful to detect the onset and extent of autonomic neuropathy in diabetic patients.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Roy
authors.forename: Sobhendu
authors.initials: S
authors.lastname: Ghatak
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D012016:Reference Values; D015203:Reproducibility of Results; D013997:Time Factors