Endocrine Abstracts

JOINT1595

Introduction: The chronic vascular complications are the most common cause of death and invalidity of diabetic patients, and cardiovascular chronic complications are the most affected. The diabetic cardiovascular autonomic neuropathy (CAN) is chronic complication of diabetes mellitus, frequently without any symptoms, and with high mortality which demands early detection.

Aim: Aim of this work was to establish: possibility of CAN early detection with the implementation of cardiovascular dynamic tests and diagnostic value each of those cardiovascular tests.

Methods: During this research we have evaluated 90 examinees: 30 of them with diabetes type 1, 30 with diabetes type 2 and 30 healthy examinees – without primary cardiac disease and diabetes. The autonomic nervous system function was examined by 5 tests for cardiovascular reflexes, with those tests we have evaluated cardiac rate reaction on various stimuli (Valsalve maneuver, deep breathing test, stand-up after lying position test) or blood pressure (orthostatic hypotension test and Hand grip test). In performing of these tests, we have used: sphygmomanometer, ECG machine, aneroid manometer and manual manometer.

Results: Results have showed that the most common pathological test in diabetes type 1 (71,4%, P< 0.001) and type 2 (83,3%, P> 0.001) was stand-up from lying position test, and afterwards deep breathing test – in diabetes type 1 (66,7%, P< 0.001) and type 2 (80,0%, P< 0.001). Valsalve maneuver, orthostatic hypotension test and Hand grip test were pathological in 33,3% of the patients with autonomic neuropathy in type 1 of diabetes, and in type 2 (46,7%, 13,3% and 20,0%).

Conclusions: The cardiovascular tests enable early detection of the presence of CAN and objective assessment of the cardiovascular function, and have great prognostic, diagnostic and therapeutic significance. Stand-up test from lying position and deep breathing test were the most often pathological in CAN patients, and therefore having the greatest diagnostic value. Cardiovascular tests should be accepted as golden standard in CAN diagnostic and put it in everyday clinical practice. Correct interpretations of these tests enable categorization of damage degree of autonomic nerve system, which has great importance in further treatment and management of these patients.