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Chapter-018 Cardiodiabetes and Autonomic Insufficiency

BOOK TITLE: Cardiodiabetes Update: A Textbook of Cardiology

Author

1. Chaturvedi Vivek
2. Bansal Ankit

ISBN

9789352703043

DOI

10.5005/jp/books/14130_19

Edition

1/e

Publishing Year

2018

Pages

Author Affiliations

1. GB Pant Hospital, New Delhi, India, G.B. Pant Hospital, Maulana Azad Medical College, New Delhi, India, Narayana Superspecialty Hospital, Gurugram, Haryana, India, Narayana Superspeciality Hospital, Gurugram, Haryana, India, Narayana Superspeciality Hospital, Gurugram, Haryana, India.
2. Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Maulana Azad Medical College, New Delhi, India, GB Pant Hospital, New Delhi, India, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER) New Delhi, India, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India

Chapter keywords

Cardiodiabetes, cardiovascular autonomic neuropathy, CAN, orthostatic hypotension, OH, heart rate disorder, blood pressure, silent myocardial ischemia, SMI, diabetic cardiomyopathy

Abstract

Abstract

The first description of cardiovascular autonomic neuropathy (CAN) in diabetes was given in 1975 by Low et al. after determining that diabetic neuropathy also compromised autonomic control of the cardiovascular system, as evidenced by orthostatic hypotension (OH) and abnormal autonomic responses to different stimuli. CAN is caused by damage to the autonomic nerve fibers that innervate the heart and blood vessels and leads to abnormalities in cardiovascular hemodynamics. Clinical manifestations of diabetic CAN include: resting heart rate (HR) disorders, exercise intolerance, intraoperative cardiovascular lability, orthostatic alterations in HR and blood pressure (BP), QTc prolongation, abnormal diurnal and nocturnal BP variations, silent myocardial ischemia (SMI), and diabetic cardiomyopathy.

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