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

The aim of this work was to study peripheral vegetative regulation of pacemaker activity of the sinus (sinoatrial) node (SN) by high resolution analysis of cardiac rhythm variability (CRV) in patients with type 1 and 2 diabetes mellitus (DM). All CRV waves in the temporal and spectral regions were shown to be reduced. Regulatory effects of SN were pathologically distributed as appears from the increase of inefficient sympatho-metabolic influence due to the decrease of sympatho-parasympathetic one. Such change and redistribution of effects of regulatory SN factors are the predictors of cardiovascular disorders associated with DM1 and DM2. The low-amplitude CRV fluctuations of certain period and frequency suggest their pathogenetic relationship with DM decompensation. They differed from normal parasympathetic lengthening of a single RR-interval due to the high speed of pulse passage along parasympathetic fibers. It is supposed that these waves with periods 2.33. ± 2.35 and 2.3 ± 2.1 s and spectral density peaks 0.23 ± 0.045 and 0.24 ± 0.16 Hz showing average and moderate correlation with clinical and laboratory data (r = 0.543 ± 0.028 in DM1 and 0.388 ± 0.034 in DM2) are markers of diabetic endotoxicosis.