Evaluation of cardiac autonomic dysfunction in patients with Type 2 DM

Abstract

Abstract

Background: Cardiovascular autonomic dysfunction is a common but often underdiagnosed complication of type 2 diabetes mellitus (T2DM) that contributes to increased cardiovascular morbidity and mortality.

Objective: To evaluate cardiac autonomic dysfunction in patients with T2DM and determine its association with clinical and metabolic characteristics.

Materials and Methods: This hospital-based cross-sectional study included 90 patients with T2DM. Clinical details, anthropometric measurements, and laboratory parameters, including glycated haemoglobin (HbA1c), were recorded. Cardiac autonomic function was assessed using Ewing's cardiovascular autonomic reflex tests. Cardiac autonomic neuropathy (CAN) was classified according to Ewing's criteria. Statistical analysis was performed using SPSS version 26.0, with p <0.05 considered statistically significant.

Results: The mean age of the participants was 56.84 ± 10.92 years, and 61.1% were males. Cardiac autonomic dysfunction was present in 56.7% of patients, with 23.3% having early CAN, 22.2% definite CAN, and 11.1% severe CAN. Abnormal Valsalva ratio (36.7%) and deep breathing test (35.6%) were the most common abnormalities. Patients with CAN had significantly older age, longer duration of diabetes, higher HbA1c, higher BMI, and a greater prevalence of hypertension (p <0.05). Duration of diabetes >10 years, HbA1c >8%, age >60 years, and hypertension were independent predictors of CAN.

Conclusion: Cardiac autonomic dysfunction is highly prevalent among patients with T2DM and is significantly associated with longer disease duration, poor glycaemic control, older age, and hypertension. Routine screening using cardiovascular autonomic reflex tests may facilitate early diagnosis and improve cardiovascular risk stratification.