Methodist Journal

IN THIS ISSUE

Diabetes and the Heart

Vol 14, Issue 4 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

The Intersection of Diabetes and Cardiovascular Disease

See More
RECOGNITIONS

Guest Editors Steven Petak and Archana Sadhu Guide Issue on Diabetes and the Heart

See More

REVIEW ARTICLES See More

Cardiac Autonomic Neuropathy in Diabetes Mellitus

Stage-Based Management of Type 2 Diabetes Mellitus with Heart Failure

Imaging to Stratify Coronary Artery Disease Risk in Asymptomatic Patients with Diabetes

Update on Management of Type 2 Diabetes for Cardiologists

New Therapeutic Strategies for Type 2 Diabetes

Prediabetes: Why Should We Care?

Central Venous Pathologies: Treatments and Economic Impact

Venous Thrombosis and Post-Thrombotic Syndrome: From Novel Biomarkers to Biology

CASE REPORTS See More

Loperamide Mimicking Brugada Pattern

Reversed Pulsus Paradoxus in Right Ventricular Failure

Mycobacterium Chimaera Mimicking Sarcoidosis

Immune Checkpoint Inhibitor Related Cardiotoxicity

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

A Right Ventricular Mass

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

The Kidney as an Endocrine Organ

EXCERPTA

The Other Side of the Prescription

EXCERPTA

Telemedicine Shakes Up the ICU Experience

POINTS TO REMEMBER

Venous Thrombosis in Nephrotic Syndrome

EDITORIALS

Letter to the Editor in response to “Role of Subcutaneous Leadless Implantable Cardioverter Defibrillator in Young Patients

Vol 14, Issue 4 (2019)

Article Abstract

Cardiac Autonomic Neuropathy in Diabetes Mellitus


Article Citation:

Agashe S, Petak S. Cardiac autonomic neuropathy in diabetes mellitus. Methodist DeBakey Cardiovasc J. 2018;14(4):251-256.

doi:

Abstract

Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as high as 90% of patients with type 1 diabetes. Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function. The pathophysiology of CAN is complex, likely multifactorial, and not completely understood. Treatment is limited to symptomatic control of orthostatic hypotension, which is a late complication, and current strategies to reverse CAN are limited. This review explores the epidemiology, pathophysiology, clinical manifestations, diagnosis, and complications of CAN as well as current treatment options.

Keywords
cardiac autonomic neuropathy , diabetes , resting tachycardia , orthostatic hypotension , heart rate variability , cardiac autonomic reflex tests , CARTs , hyperglycemia , parasympathetic , cardiovagal , sympathetic , Valsalva , silent ischemia , DCCT study , EDIC study , perioperative mortality , exercise intolerance , EURODIAB study , glycosylation , reactive oxygen species , microvascular complications , diabetic neuropathy , Toronto Consensus Panel