Key result
Cardiac autonomic neuropathy is a frequent complication of diabetes that increases the risk of sudden cardiac death, and early diagnosis using heart rate variability can improve prognosis.
Cardiologists should actively screen diabetic patients for cardiac autonomic neuropathy using widely available ECG-based heart rate variability methods to improve prognosis.
May support HRV screening in diabetes; leaves open whether implementation improves outcomes in prospective trials.
BACKGROUND: Cardiac autonomic neuropathy (CAN) is a frequent but underdiagnosed complication of diabetes mellitus. It has a strong influence on various cardiac disorders including myocardial ischemia and infarction, hypertension, orthostatic hypotonia, heart failure, and arrhythmias. CAN can lead to severe morbidity and mortality and increase the risk of sudden cardiac death. METHODS: This review article summarizes the latest evidence regarding the epidemiology, pathogenesis, influence on the cardiovascular system, and diagnostic methods for CAN. The methodology of this review involved analyzing available data from recent papers relevant to the topic of diabetic autonomic neuropathy and cardiac disorders. CONCLUSIONS: The early diagnosis of CAN can improve the prognosis and reduce adverse cardiac events. Methods based on heart rate variability enable the diagnosis of CAN even at a preclinical stage. These methods are simple and widely available for use in everyday clinical practice. According to the recently published Toronto Consensus Panel on Diabetic Neuropathy, all diabetic patients should be screened for CAN. Because diabetes mellitus often coexists with heart diseases and the most common methods used for diagnosis of CAN are based on ECG, not only diabetologists but also cardiologists should be responsible for diagnosis of CAN.
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Andrzej Bissinger (2017) conducted a review in Cardiac autonomic neuropathy. Cardiac autonomic neuropathy was evaluated. Cardiac autonomic neuropathy is a frequent complication of diabetes that increases the risk of sudden cardiac death, and early diagnosis using heart rate variability can improve prognosis.
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