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Related Experiment Videos

Diabetic cardiac autonomic dysfunction: parasympathetic versus sympathetic.

A Uehara1, C Kurata, T Sugi

  • 1Department of Medicine III, Hamamatsu University School of Medicine, Japan. hiro26@hama-med.ac.jp

Annals of Nuclear Medicine
|June 4, 1999
PubMed
Summary

Diabetic cardiac autonomic dysfunction involves both parasympathetic and sympathetic systems. Heart rate variability (HRV) and 123I-Metaiodobenzylguanidine (MIBG) imaging show these dysfunctions correlate in diabetic patients.

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Area of Science:

  • Cardiology
  • Diabetology
  • Autonomic Nervous System Research

Background:

  • Diabetic cardiac autonomic dysfunction is a significant cause of lethal arrhythmia and sudden cardiac death.
  • 123I-Metaiodobenzylguanidine (MIBG) imaging assesses cardiac sympathetic nerve function.
  • Heart rate variability (HRV) analysis evaluates cardiac parasympathetic activity.

Purpose of the Study:

  • To investigate the correlation between cardiac parasympathetic dysfunction (assessed by HRV) and sympathetic dysfunction (assessed by MIBG) in diabetic patients.

Main Methods:

  • 24-hour electrocardiography to analyze HRV parameters (HF, EMHF, rMSSD, pNN50).
  • 123I-Metaiodobenzylguanidine (MIBG) planar imaging and SPECT to calculate heart washout rate and defect scores (DS) at early and late phases.

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  • Analysis of correlations between HRV parameters and MIBG findings in diabetic patients without heart failure, coronary artery disease, or renal failure.

    • Main Results:

    • Parasympathetic HRV parameters showed a negative correlation with late MIBG defect scores (R = -0.47 to -0.59, p < 0.05) and washout rate (R = -0.50 to -0.55, p < 0.05) in 20 selected diabetic patients.
    • In 64 diabetic patients, HRV parameters also correlated negatively with both early and late MIBG defect scores (R = -0.27 to -0.35, p < 0.05).

    Conclusions:

    • The progression of diabetic cardiac parasympathetic dysfunction appears to parallel the progression of sympathetic dysfunction.