Evaluation of cardiac autonomic neuropathy in diabetes mellitus using electrocardiographic changes and ANSiscope device

Abstract

Aim

1. Evaluation of cardiac autonomic neuropathy in diabetes mellitus. Patient using electro cardio graphic changes of heart rate variability.


2. To correlate the ECG changes with beat to beat variation using ANSiscope device.

Materials

Study population

50 diabetic patients attending Diabetology Outpatient Department, of RMMCH, Chidambaram. These subjects were selected after scrutinizing them for exclusion criteria.

Control populations

50 patients attending General Medical Outpatient Department at RMMCH, Chidambaram. These subjects were age matched controls.

Place of study

Diabetology Outpatients Department, RMMCH, Chidambaram

Period of study

November 2013 - April 2015.

Inclusion criteria

Male patients attending the diabetic outpatient Department of RMMCH.

Exclusion criteria

1. Age – Greater than 65 years.


2. Known case of coronary artery disease with electrocardiogram changes like ST segment elevation ? 2mm in the chest leads or ?1mm in limb leads in the corresponding leads.


3. Known case of valvular or congenital heart disease by echocardiogram.


4. Systemic hypertension


5.  

Methodology

After selecting the patients on basis of the criteria history will be elicited and clinical examination done as per proforma. The necessary investigations [fasting blood sugar, post prandial blood sugar, ECG, ANIscope] will be done and statistically analyzed.

Conclusion

• The resting heart rate (86.16±7.6) was significantly (P<0.05) higher than that of non diabetic controls (76.64±9.18).


• There was a leftward deviation of QRS axis among diabetics (31.6°) as compared to controls (54°).


• QTc interval was prolonged (400.62 ± 32.18 msec) in diabetic study population which was significant (P0.0000).

Cardiac dysautonomia was demonstrated in the study population using the following parameters.

• Abnormal E:I ratio (<1.1) (50%).


• Postural fall in systolic blood pressure (>10mmHg) (42%)


• Ratio of 10^th RR interval to 5^th RR interval was abnormal in (60%).


• Dyansys ANSi scope score was abnormal in 80% of the study group.