National Journal of Physiology, Pharmacy and Pharmacology

2019, Vol: 9, Issue: 7

9/7Current Issue Online First Archive Aims and Scope Abstracting & Indexing Most Accessed Articles Most Downloaded Articles Most Cited Articles

Required files to uploaded

« Previous Article

Original Research

Natl J Physiol Pharm Pharmacol. 2014; 4(1): 34-38

doi: 10.5455/njppp.2014.4.080720131

Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode.

Cited by (6)

Abstract
Background: Cardiovascular Autonomic Diabetic Neuropathy (CADN) is one of the most important diabetes- associated complications. Reduced heart rate variation (HRV) is the earliest indicator of CADN. The prospect of using time domain analysis of HRV using mental arithmetic as a stressor has for early diagnosis of CADN has not been studied so far.

Aims & Objective: To compare time domain parameters of HRV at rest and during acute mental stress between Type 2 diabetics and non- diabetics.

Materials and Methods: 30 male asymptomatic, Type 2 diabetics with duration of diabetes of 2-8 yrs with RBS ≥ 200 mg/dl or FBS ≥ 126 mg/dl in the age group of 30-65 yrs were chosen as subjects. 30 age and sex matched healthy non-diabetics were chosen as controls. HRV analysis was done using ECG recorded at rest in supine position for 5 min and during 5 min of acute mental stress testing.

Results: At rest standard deviation of all R-R intervals (SDNN), root mean square of successive RR- interval differences (RMSSD), number of intervals differing by > 50ms from adjacent interval (NN50) and percentage of NN50 (pNN50) were significantly less in diabetics as compared to non- diabetics. Mental stress showed increases in HR, SBP and DBP in non-diabetics as well as diabetics but SDNN was significantly less in diabetics as compared to non- diabetics during stress.

Conclusion: Data from the study demonstrated that diabetics with 8-10 yrs history had already developed parasympathetic autonomic neuropathy. Time domain analysis of HRV during mental stress can be used as a valuable tool for early diagnosis of autonomic neuropathy to prevent further complications.

Key words: Heart rate variability, Time Domain Analysis, Cardiovascular Diabetic Autonomic Neuropathy

	ARTICLE TOOLS
	Abstract
	PDF Fulltext
	Print this Article
	How to cite this article
	Citation Tools
	Related Records
	Articles by Anupama Deepak Articles by Deepak A N Articles by Shobha Nallulwar Articles by Vitthal Khode
	on Google
	on Google Scholar
	Article Statistics
	Viewed: 7645 Downloaded: 1931 Cited: 6

REFERENCES

1. Vinik AI, Erbas T. Recognizing and treating diabetic autonomic neuropathy. Cleve Clin J Med.2001; 68: 928- 944. [DOI via Crossref]

2. American Diabetes Association and American Academy of Neurology. Report and recommendations of San Antonio Conference on diabetic neuropathy (Consensus Statement). Diabetes. 1988; 37: 1000- 1004. [DOI via Crossref]

3. Pfeifer MA, Weinberg CR, Cook DL, Reenan A, Halter JB, Ensinck JW, et al. Autonomic neural dysfunction in recently diagnosed diabetic subjects. Diabetes Care. 1984; 7: 447-453. [DOI via Crossref]

4. Howorka K, Pumprla J, Haber P, Koller-Strametz J, Mondrzyk J, Schabmann A. Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy. Cardiovasc Res. 1997; 34(1):206-14. [DOI via Crossref]

5. Maser R, Lenhard M, DeCherney G. Cardiovascular autonomic neuropathy: the clinical significance of its determination. Endocrinologist. 2000; 10: 27-33. [DOI via Crossref]

6. Kudat H, Akkaya V, Sozen AB, Salman S, Demirel S, Ozcan M et al. Heart rate variability in diabetic patients. J Int Med Res. 2006; 34: 291- 296. [DOI via Crossref]

7. Lafitte MJ, Fevre-Genoulaz M, Srikanta SS, Punitha L, Vidyanand S. 500 heart beats for assessing diabetic autonomic neuropathy. Int J Diab Dev Countries. 2005; 25: 113- 117. [DOI via Crossref]

8. Al-Hazimi A, Al-Ama N, Syiamic A, Qosti R, Abdel-Galil K. Time-domain analysis of heart rate variability in diabetic patients with and without autonomic neuropathy. Ann Saudi Med. 2002; 22(5-6):400-403.

9. Uehara A, Kurata C, Sugi T, Mikami T, Shouda S. Diabetic cardiac autonomic dysfunction: parasympathetic versus sympathetic. Ann Nucl Med. 1999;13(2):95-100. [DOI via Crossref]

10. Ahamed Seyd PT, Thajudin Ahamed VI, Jeevamma J, Paul J K. Time and frequency domain analysis of heart rate variability and their correlations in diabetes mellitus. International Journal of Biological and Life Sciences. 2008; 4(1): 24- 27

11. Stoickov V, Ilic S, Deljanin Ilic M, Nikolic A, Mitic V. Impact of diabetes on heart rate variability and left ventricular function in patients after myocardial infarction. Facta Universitatis, Series: Medicine and Biology. 2005; 12(3): 130- 134.

12. Tale S, Sontakke TR. Heart rate variability analysis a non- invasive clinical screening tool to detect functional ability of diabetic cardiac autonomic neuropathy. Int J Comput Appl. 2011;25(10):47-51.

13. Arati R, Prashanthmohan BH, Ganaraja B, Bhat MR. Cardiac autonomic functions are compromised in diabetes mellitus- A study of south Indian elderly patients. International Journal of Applied Biology and Pharmaceutical Technology. 2011; 2(3): 502-511.

14. Steptoe A, Vögele C. Methodology of mental stress testing in cardiovascular research. Circulation. 1991; 83(4 Suppl):II14-24.

15. Callister R, Suwarno NO, Seals DR. Sympathetic activity is influenced by task difficulty and stress perception during mental challenge in humans. J Physiol. 1992; 454: 373-87.

16. Pagani M, Ferrari A, Liberati D, Cerutti S, Vaitl D, Tavazzi L, et al. Sympathovagal interaction during mental stress. Circulation. 1991; 83(4)(suppl II): II-43─ II- 51.

17. Locatelli A, Franzetti I, Lepore G, Maglio ML, Gaudio E, Caviezel F, et al. Mental arithmetic stress as a test for evaluation of diabetic sympathetic autonomic neuropathy. Diabet Med. 1989; 6(6): 490- 495. [DOI via Crossref]

18. Yadav RK, Gupta R, Deepak KK. A pilot study on short term heart rate variability and its correlation with disease activity in Indian patients with rheumatoid arthritis. Indian J Med Res. 2012; 136: 593-598.

19. Middlekauff HR, Nguyen AH, Negrao CE, Nitzsche EU, Hoh CK, Natterson BA, et al. Impact of acute mental stress on sympathetic nerve activity and regional blood flow in advanced heart failure. Circulation. 1997; 96: 1835- 1842. [DOI via Crossref]

20. Evrengül H, Tanriverdi H, Dursunoglu D, Kaftan A, Kuru O, Unlu U, et al. Time and frequency domain analyses of heart rate variability in patients with epilepsy. Epilepsy Res. 2005; 63(2-3):131-139. [DOI via Crossref]

21. Tarvainen MP, Lipponen JA, Al- Aubaidy H, Jelinek HF. Effect of hyperglycemia on cardiac autonomic function in Type 2 diabetes. Comput Cardiol. 2012; 39: 405- 408.

22. Bernardi L, Wdowczyk-Szulc J, Valenti C, Castoldi S, Passino C, Spadacini G, et al. Effects of controlled breathing, mental activity and mental stress with or without verbalization on heart rate variability. J Am Coll Cardiol. 2000; 35: 1462- 1469. [DOI via Crossref]

23. Rajaram DP, Karthikeyan R, Saikumar P. The cardiovascular response to the acute physical and mental stress in type 2 diabetes mellitus. J Clin Diagn Res. 2012; 6(7): 1237- 1240.

24. Carter JR, Ray CA. Sympathetic neural responses to mental stress: responders, nonresponders and sex differences. Am J Physiol Heart Circ Physiol. 2009; 296(3): H847- H853 [DOI via Crossref]

25. Perusse- Lachance E, Tremblay A, Chaput JP, Poirier P, Teasdale N, Drapeau V, et al. Mental work stimulates cardiovascular responses through a reduction in cardiac parasympathetic modulation in men and women. Bioenergetics. 2012; S1:001.

26. Vinik AI, Maser RE, Zeigler D. Autonomic imbalance: prophet of doom or scope of hope? Diabet Med. 2011;28(6):643-51. [DOI via Crossref]

27. Freccero C, Svensson H, Bornmyr S, Wollmer P, Sundkvist G. Sympathetic and parasympathetic neuropathy are frequent in both Type 1 and Type 2 diabetic patients. Diabetes Care. 2004;27(12): 2936- 41. [DOI via Crossref]

28. Hsiao JY, Tien KJ, Hsiao CT, Weng HH, Chung TC, Hsieh MC. The relationship between diabetic autonomic neuropathy and diabetic risk factors in a Taiwanese population. J Int Med Res. 2011; 39: 1155- 1162. [DOI via Crossref]

29. Mudassir Mirza and Laxmi ANR: A comparative study of heart rate variability in diabetic subjects and normal subjects. Int J Biomed Adv Res. 2012; 3(8): 640- 644.

30. Task force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996. Heart rate variability, standards of measurement, physiological interpretation, and clinical use. Circulation. 1996; 93: 1043- 1065. [DOI via Crossref]

31. Nunan D, Sandercock GR, Brodie DA. A Quantitative Systematic Review of Normal Values for Short-term Heart Rate Variability in Healthy Adults. Pacing Clin Electrophysiol. 2010;33(11):1407-1417. [DOI via Crossref]

32. Mukherjee S, Yadav R, Yung I, Zajdel DP, Oken BS. Sensitivity to mental effort and test- retest reliability of heart rate variability measures in healthy seniors. Clin Neurophysiol. 2011; 122(10): 2059-2066.

This Article Cited By the following articles

Fusion of heart rate variability and salivary cortisol for stress response identification based on adverse childhood experience Med Biol Eng Comput 2019; (): .	1

Fighter pilots’ heart rate, heart rate variation and performance during instrument approaches Ergonomics 2016; (): 1.	2

Fighter pilots' heart rate, heart rate variation and performance during an instrument flight rules proficiency test Applied Ergonomics 2016; 56(): 213.	3

Physiological evidence for a human-induced landscape of fear in brown bears (Ursus arctos) Physiology & Behavior 2015; 152(): 244.	4

Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load Proceedings of the National Academy of Sciences 2014; 111(44): 15693.	5

0; (): 140.	6

How to Cite this Article

Pubmed Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. Natl J Physiol Pharm Pharmacol. 2014; 4(1): 34-38. doi:10.5455/njppp.2014.4.080720131

Web Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. http://www.njppp.com/?mno=40570 [Access: July 16, 2019]. doi:10.5455/njppp.2014.4.080720131

AMA (American Medical Association) Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. Natl J Physiol Pharm Pharmacol. 2014; 4(1): 34-38. doi:10.5455/njppp.2014.4.080720131

Vancouver/ICMJE Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. Natl J Physiol Pharm Pharmacol. (2014), [cited July 16, 2019]; 4(1): 34-38. doi:10.5455/njppp.2014.4.080720131

Harvard Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode (2014) Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. Natl J Physiol Pharm Pharmacol, 4 (1), 34-38. doi:10.5455/njppp.2014.4.080720131

Turabian Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. 2014. Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. National Journal of Physiology, Pharmacy and Pharmacology, 4 (1), 34-38. doi:10.5455/njppp.2014.4.080720131

Chicago Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode. "Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study." National Journal of Physiology, Pharmacy and Pharmacology 4 (2014), 34-38. doi:10.5455/njppp.2014.4.080720131

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode (2014) Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study. National Journal of Physiology, Pharmacy and Pharmacology, 4 (1), 34-38. doi:10.5455/njppp.2014.4.080720131



Copyright � 2019 National Journal of Physiology, Pharmacy and Pharmacology All Rights Reserved. Subject to change without notice from or liability to National Journal of Physiology, Pharmacy and Pharmacology. For best results, please use Internet Explorer or Google Chrome	Contact Information Publisher Dipika Charan 404 Ridhi Tower Jodhpur, India 342005 publishernjppp@gmail.com Editorial query editornjppp1@gmail.com 91-878-0040272

Contact Information