[PERIPHERAL AUTONOMOUS REGULATION OF SINUS (SINOATRIAL) NODE IN TYPE 1 AND 2 DIABETES MELLITUS].

Area of Science:

• Cardiology
• Endocrinology
• Autonomic Nervous System Research

Context:

• Diabetes mellitus (DM) significantly impacts cardiovascular health.
• Peripheral vegetative regulation of the sinoatrial node (SN) is crucial for cardiac function.
• High-resolution analysis of cardiac rhythm variability (CRV) offers insights into autonomic control.

Purpose:

• To investigate the impact of type 1 and type 2 diabetes mellitus on the peripheral vegetative regulation of SN pacemaker activity.
• To analyze CRV patterns in diabetic patients using high-resolution techniques.
• To identify potential CRV markers associated with cardiovascular disorders and diabetic decompensation.

Summary:

• Analysis revealed reduced CRV waves in both temporal and spectral domains in diabetic patients.
• Pathological redistribution of SN regulatory effects was observed, with decreased sympatho-parasympathetic influence and increased sympatho-metabolic influence.
• Low-amplitude CRV fluctuations with specific periods (2.33 ± 2.35s, 2.3 ± 2.1s) and spectral peaks (0.23 ± 0.045Hz, 0.24 ± 0.16Hz) correlate with clinical data and may indicate diabetic endotoxicosis.

Impact:

• Altered SN regulation and CRV patterns are predictors of cardiovascular disorders in type 1 and type 2 DM.
• Identified CRV fluctuations may serve as novel biomarkers for diabetic decompensation and endotoxicosis.
• Findings contribute to understanding the complex interplay between diabetes, autonomic dysfunction, and cardiovascular risk.