IMPACT OF DIABETES ON HEART RATE VARIABILITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
AbstractBackground: Diabetes is a well-known cause of sudden mortality. Due to autonomic imbalance,those patients who are suffering from ischemic heart disease and diabetes concurrently are at agreater risk of manifesting arrhythmias. Heart rate variability (HRV) can be utilised for assessmentof autonomic nervous system. The purpose of this study was to identify the values of HRV indiabetic and non-diabetic patients with acute myocardial infarction (AMI). Methods: This noninterventional descriptive study was carried out at Armed Forces Institute of Cardiology over aperiod of 6 months. A total of 50 healthy volunteers and 50 patients with myocardial infarction(MI) were Holter monitored for 24 hours and HRV was analysed in time and frequency domains.Results: The time domain indices; SDNN (non diabetics=78±30 ms vs diabetics=58±20 ms;p=0.01), SDANN (non diabetics=68±28 ms vs diabetics=49±19 ms; p=0.23), SDNNi (nondiabetics=36±13 ms vs diabetics=26±14 ms; p=0.02), RMSSD (non diabetics=29±11 ms vsdiabetics=23±15 ms; p=0.16) and pNN50 (non diabetics=7±10 ms vs diabetics=4±12 ms; p=0.43)were declined in diabetic patients with acute myocardial infarction when compared with nondiabetic patients inflicted with infarction. Frequency domain indices, Total power (nondiabetics=1479±12 ms2 vs diabetics=759±6 ms2, p=0.01), VLF (non diabetics=997±9 ms2 vsdiabetics=495±5 ms2, p=0.04), LF (non diabetics=292±2 ms2 vs diabetics=123±1 ms2, p=0.01)and HF (non diabetics=121±1 ms2 vs diabetics=54±5 ms2, p=0.01) showed attenuated HRV indiabetic patients with acute myocardial infarction. Comparison of diabetic and non diabeticinfracted patients with healthy volunteers revealed decreased HRV in patients with myocardialinfarction but gets even worse in diabetic patients with myocardial infarction. Conclusions: Heartrate variability is attenuated in diabetic patients with acute myocardial infarction. It reflectssympatho-vagal imbalance in coronary patients with co-existent diabetes mellitus.Keywords: Autonomic nervous system, diabetes mellitus, ambulatory electrocardiography
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