Baroreflex sensitivity predicts cardiovascular events in patients with type 2 diabetes mellitus without structural heart disease

Circ J. 2010 Jul;74(7):1379-83. doi: 10.1253/circj.cj-09-0960. Epub 2010 Apr 29.

Abstract

Background: Cardiovascular autonomic neuropathy is a major complication in patients with diabetes mellitus (DM). However, the relationship between cardiovascular autonomic neuropathy and the incidence of cardiovascular events has been poorly investigated in type 2 DM. The present study aimed to assess the long-term cardiovascular predictive value of baroreflex sensitivity (BRS) in Japanese patients with type 2 DM without structural heart disease.

Methods and results: BRS was evaluated using the phenylephrine method in 210 patients with type 2 DM who did not have structural heart disease or other severe complications. BRS was considered depressed if <6 ms/mmHg. Accurate follow-up information for 3-10 years (mean 4.7 years) was obtained in 184 patients (90 females, 94 males; mean age 58+/-12 years). The initial onset of a major adverse cardiovascular event (MACE) was investigated. During follow-up, 19 patients presented with a MACE (4 cardiovascular deaths, 3 nonfatal myocardial infarctions, 4 coronary revascularizations, 5 strokes, 2 congestive heart failures). Cox proportional hazards regression analysis revealed that depressed BRS was independently associated with the incidence of MACE (hazard ratio 1.93, 95% confidence interval 1.09-3.82, P=0.0236).

Conclusions: Depressed BRS at baseline has long-term cardiovascular predictive value in Japanese patients with type 2 DM without structural heart disease.

MeSH terms

  • Aged
  • Baroreflex / physiology*
  • Cardiovascular Diseases / diagnosis*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Follow-Up Studies
  • Heart Diseases
  • Humans
  • Incidence
  • Japan
  • Male
  • Middle Aged
  • Phenylephrine
  • Predictive Value of Tests*

Substances

  • Phenylephrine