title: Clinical usefulness of baroreflex sensitivity test in the detection of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus.
abstract: Cardiovascular autonomic neuropathy (CAN) is one of the most common chronic complications of diabetes. It is defined as an impaired control of the cardiovascular system by the autonomic nervous system. The gold standard in detecting it is the Ewing test suite. The usefulness of other methods is still a subject of research.
  
  
  OBJECTIVE
  The aim of this study was to assess the clinical usefulness of baroreflex sensitivity (BRS) test in the detection of CAN in patients with type 2 diabetes mellitus.
  
  
  METHODS
  The study included diabetic patients: 24 with CAN, diagnosed through the Ewing tests (the mean age 58 ± 7 years, BMI 33.6 ± 5 kg*m⁻², HbA1c% 8.3 ± 3, duration of diabetes 13.3 ± 7 years), and 24 without CAN (56 ± 8 years, BMI 32.2 ± 5 kg*m-2, HbA1c% 9.1 ± 2, 9.3 ± 9 years, respectively). The control group consisted of 12 patients without diabetes, homogeneous regarding gender and age. BRS was assessed in the supine (L-BRS), and in the standing position (S-BRS).
  
  
  RESULTS
  L-BRS was lower in the group with CAN vs the non-CAN group (6.2 ± 4 vs 9.6 ± 4 ms/mmHg; p=0,009); S-BRS respectively (4.4 ± 3 vs 6.9 ± 4 ms/mmHg; p=0.02). BRS well differentiates patients with and without polyneuropathy. The highest sensitivity of L-BRS and SBRS for detecting CAN is by cutoff ≤ 7 ms/mmHg.
  
  
  CONCLUSIONS
  The study confirms the value of baroreflex sensitivity in the early detection of CAN among patients with type 2 diabetes. We recommended cutoff points for BRS to detect CAN among patients with type 2 diabetes mellitus.
authors.affiliation: Department of Interventional Cardiology and Cardiac Arrhythmias, Medical University of Lodz, Poland.
authors.forename: Emila
authors.initials: E
authors.lastname: Borowik
authors.affiliation: Department of Interventional Cardiology and Cardiac Arrhythmias, Medical University of Lodz, Poland.
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Grabowicz
authors.affiliation: Department of Interventional Cardiology and Cardiac Arrhythmias, Medical University of Lodz, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grycewicz
authors.affiliation: Department of Interventional Cardiology and Cardiac Arrhythmias, Medical University of Lodz, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lubiński
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology; D017704:Baroreflex; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: baroreflex sensitivity; cardiovascular autonomic neuropathy; type 2 diabetes mellitus