Use of the Polar H10 cardiofrequencemeter and Ewing's autonomic function tests in the screening of cardiac autonomic neuropathy in type 1 diabetes mellitus in Yaoundé - 06/01/20
Résumé |
Background |
Cardiac autonomic neuropathy (CAN) is one of the chronic complications of diabetes that can be detected by studying spontaneous or induced changes in heart rate and blood pressure.
Purpose |
To investigate and characterize CAN in a group of young type 1 diabetics patients.
Methods |
This was a cross sectional study carrying out in Yaounde Central Hospital. We successively realize a clinical examination, rest electrocardiogram, 3min heart rate variability measure and five Ewing's functions tests (heart rate response, orthostatic blood pressure, vasalva test, control ventilation and forearm isometric contraction) with a POLAR H10 cardiofrequencemeter. Quantitative variables were express by the mean and his standard deviation; qualitative variables were expressed using frequencies.
Results |
Sixty type 1 diabetics patients (37 males and 33 females) with a sex ratio of 1.6. The mean age was 19,6±4.3 years, with diabetes of duration 5.9±5.1 year, a mean BMI of 21.7±2.9kg/m2 and a mean HbA1c of 9.1±3.1%. Prevalence of CAN was 86.7%. The mean heart rate at rest was 82.9±14.7bpm, a systolic blood pressure of 116.8±18.9mmHg, diastolic blood pressure of 70.4±11.8mmHg. The orthostatic blood pressure response was abnormal, restrict, normal respectively for 1 (1.7%), 5 (8.3%) and 54 (90%) subjects. The orthostatic response of the heart rate was abnormal for 20% of subjects and restrict for 10%. 28.3% of subjects had an abnormal Valsalva test. We found an abnormal forearm isometric contraction for 90% of subjects. The HRV index for parasympathetic activity were down low for 93.3% while index for orthosympathetic activity were down low for 90% of subjects.
Conclusion |
CAN is frequent in type 1 diabetes patients. The five Ewing and Clarke tests are replicable in clinical practice with the H10 polar cardiofrequencemeter. Thus, developing a single standard and universal consensus for the interpretation of these tests is important for a better screening of CAN.
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Vol 12 - N° 1
P. 193 - janvier 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.