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Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes.
Diabet Med. 2008 Nov; 25(11):1366-9.DM

Abstract

BACKGROUND

In Type 1 diabetes mellitus (DM), it has been suggested that autonomic nervous system dysfunction (NAD) impairs lung diffusion capacity. Heart rate variability (HRV), a measure of cardiac autonomic function, is a sensitive method of detecting NAD. To our knowledge, no previous study has assessed whether cardiac sympatho-vagal balance is associated with lung diffusion capacity in diabetes.

METHODS

Twenty Type 1 DM patients without pulmonary abnormalities and systemic NAD underwent measurement of lung diffusion capacity for carbon monoxide (DLCO) by single-breath method and assessment of cardiac autonomic function by HRV analysis on 24-h electrocardiographic Holter recordings.

RESULTS

Standard respiratory function tests and peripheral autonomic tests were normal in all patients. DLCO was lower than normal reference values in six patients (30%). DLCO correlated significantly with most HRV variables, independent of the clinical and laboratory variables. The strongest correlation was found with standard deviation of all RR intervals (SDNN; r = 0.62, P = 0.003) in the time domain and low frequency (LF) power (r = 0.73, P < 0.001) in the frequency domain.

CONCLUSIONS

In Type 1 diabetes, a significant association exists between cardiac NAD and reduced DLCO in the absence of clinical respiratory and autonomic abnormalities. Thus, NAD may be involved in the early reduction of DLCO in these patients, possibly through abnormalities in the regulation of pulmonary blood flow at the microvascular level.

Authors+Show Affiliations

Cardiology Institute, Catholic University, Rome, Italy. dario.pitocco@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19046231

Citation

Pitocco, D, et al. "Association Between Reduced Pulmonary Diffusing Capacity and Cardiac Autonomic Dysfunction in Type 1 Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 25, no. 11, 2008, pp. 1366-9.
Pitocco D, Santangeli P, Fuso L, et al. Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes. Diabet Med. 2008;25(11):1366-9.
Pitocco, D., Santangeli, P., Fuso, L., Zaccardi, F., Longobardi, A., Infusino, F., Incalzi, R. A., Lanza, G. A., Crea, F., & Ghirlanda, G. (2008). Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 25(11), 1366-9. https://doi.org/10.1111/j.1464-5491.2008.02571.x
Pitocco D, et al. Association Between Reduced Pulmonary Diffusing Capacity and Cardiac Autonomic Dysfunction in Type 1 Diabetes. Diabet Med. 2008;25(11):1366-9. PubMed PMID: 19046231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes. AU - Pitocco,D, AU - Santangeli,P, AU - Fuso,L, AU - Zaccardi,F, AU - Longobardi,A, AU - Infusino,F, AU - Incalzi,R A, AU - Lanza,G A, AU - Crea,F, AU - Ghirlanda,G, PY - 2008/12/3/pubmed PY - 2009/2/21/medline PY - 2008/12/3/entrez SP - 1366 EP - 9 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 25 IS - 11 N2 - BACKGROUND: In Type 1 diabetes mellitus (DM), it has been suggested that autonomic nervous system dysfunction (NAD) impairs lung diffusion capacity. Heart rate variability (HRV), a measure of cardiac autonomic function, is a sensitive method of detecting NAD. To our knowledge, no previous study has assessed whether cardiac sympatho-vagal balance is associated with lung diffusion capacity in diabetes. METHODS: Twenty Type 1 DM patients without pulmonary abnormalities and systemic NAD underwent measurement of lung diffusion capacity for carbon monoxide (DLCO) by single-breath method and assessment of cardiac autonomic function by HRV analysis on 24-h electrocardiographic Holter recordings. RESULTS: Standard respiratory function tests and peripheral autonomic tests were normal in all patients. DLCO was lower than normal reference values in six patients (30%). DLCO correlated significantly with most HRV variables, independent of the clinical and laboratory variables. The strongest correlation was found with standard deviation of all RR intervals (SDNN; r = 0.62, P = 0.003) in the time domain and low frequency (LF) power (r = 0.73, P < 0.001) in the frequency domain. CONCLUSIONS: In Type 1 diabetes, a significant association exists between cardiac NAD and reduced DLCO in the absence of clinical respiratory and autonomic abnormalities. Thus, NAD may be involved in the early reduction of DLCO in these patients, possibly through abnormalities in the regulation of pulmonary blood flow at the microvascular level. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/19046231/Association_between_reduced_pulmonary_diffusing_capacity_and_cardiac_autonomic_dysfunction_in_Type_1_diabetes_ L2 - https://doi.org/10.1111/j.1464-5491.2008.02571.x DB - PRIME DP - Unbound Medicine ER -