| PrefaceDiabetic cardiovascular autonomic neuropathy (CAN) results from damage to the autonomic nerve fiber that innervate the heart and blood vesssels and results in abnormalities in heart rate. CAN is the most serious complication of diabetes , it is overlooked without acute and sensitive indexes at present. In aepide-miological study among individuals diagnosed DM, it was shown that the 5 - year mortality rate is five times higher for individuals with CAN than for individuals without CAN. Identification of silent myocardial ischemia / infarction and sudden death is clear after earlier diagnosis of CAN, then the mortality of cardiac disease may be hardly decreased.In the past, seven conventional tests of autonomic nervous function assessed CAN. They require active patient participation, which is difficult to standardize. It is reported that reduced heart rate variation is the earliest indicator of CAN. Heart rate variability ( HRV) presents a fine tuning of the beat-to-beat control and is produced by the modulatory effect of autonomic system on the sinus node. Heart rate fluctuations can be quantified. Spectral analysis reduces an electro-cardiographic signal to the sum of its component sine waves of different amplitudes and frequencies. Heat rate fluctuations can be displayed using this technique. Power spectral analysis (PSA) may provide a useful noninvasive technique for analyzing CAN.In order to prevent CAN efficiently, we explore the predictors through screening the efficacious parameters in PSA of HRV.Objective1. To detect the method of early diagnosis of diabetic cardiovascular auto-nomic neuropathy.2. To evaluate predictive factors of evolving diabetic caridovascular neuropathy.Patients and methods1. Patients:diabetic patients ( n = 104 age; 14 -84 yr) had conventional tests of auto-nomic function and analysis of the heart rate performed. All patients were divided into four groups ( DW group, DE group, DI group, DA group). To record the clinical characteristics the results of the ECG and the EMG of all patients, ll had been proved that the normal controls had been without hypertension, without cardiopathy and without cerebrovascular disease.2. Methods:(1)7 conventional tests of autonomic function were performed with the diabetic patients.(2)According to the results of the golden conventional test, all diabetic patients were divided into 4groups.(3)PSA of HRV was performed with all patients. The results were printed.(4)The clinical characteristics of the 4groups were recorded.(5)All data were analysis by SPSS 10. 0 statistical software. Enumeration data were analyzed by variance test. The relation between variables was analyzed with linear regression. All measurement data are expressed as the Mean ?SEM. Analyzing the variances of HRV between groups with multiple linear regression analysis, found the predictors of CAN.Resultsl.The most of HRV measurements ( VLF LF HF TP Var LF ) were significantly lower than those of the normal controls. ( P < 0. 05). There was no difference in the measurements of LF/HF and HF between groups. Measurements of HRV in diabetic subjects and normal controlsNormal Diabetic without compared with normal controls P < 0. 05;" compared with diabetic patients without CAN P < 0.05, compared with diabetic patients without CAN P <0.01 ,ç™±ompared with diabetic patients in early stage of CAN P<0.052. Using the sensitive indexes as independents, multiple linear regression a-nalysis was performed in order to disclose predictors among the clinical characteristics. Age diabetic duration hypertension overt albuminuria hypercholester-mia and female were correlated with CAN.DiscussionsCAN results from the damage to the autonomic nerve fibers that innervate the heart and blood vessels and results in abnormalities in heart rate control and vascular dynamics. The most popular complication of diabetes is CAN. It is demonstrated an association between CAN silent myocardial ischemia/infarction and orthostatic hypotentsion. In literatures, it was shown that the 5 - year mor-...
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