Diagnosing Cardiovascular Autonomic Neuropathy in Type 2 Diabetic Patients with Subacute ST Elevation Myocardial Infarction

The aim of the investigation is to develop criteria for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus (DM2) in the sub-acute stage of ST-elevation myocardial infarction (STEMI).

Materials and Methods. The study involved 54 patients with STEMI without previous coronary history, who underwent reperfusion therapy, among them 27 patients suffered from DM2 (group 1), 27 individuals had no carbohydrate metabolism disorders (group 2). Group 3 consisted of 23 DM2 patients without cardiovascular pathology. All patients had sinus rhythm.

Five Ewing’s cardiovascular reflex tests were performed on day 10–14 after STEMI development. The heart rate variability was analyzed using a five-minute electrocardiogram recording. The following values were calculated: standard deviation of NN intervals, total spectrum power, and scatterogram parameters: the length of the “cloud”, its width and area.

Results. The study of heart rate variability by scatterogram analysis has proved to be preferable for diagnosing cardiovascular autonomic neuropathy in patients with DM2 and the subacute stage of STEMI.

Conclusion. A criterion for the presence of diabetic cardiovascular autonomic neuropathy is the scatterogram “cloud” area value S≤571 ms². This criterion can be used to diagnose the disease in the population of DM2 patients with a sub-acute stage of myocardial infarction.

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Bushuyeva A.V., Botova S.N., Pochinka I.G., Morozova E.P., Frolov A.A., Strongin L.G. Diagnosing Cardiovascular Autonomic Neuropathy in Type 2 Diabetic Patients with Subacute ST Elevation Myocardial Infarction. Sovremennye tehnologii v medicine 2016; 8(2): 53, https://doi.org/10.17691/stm2016.8.2.07