Abnormal autonomic function in diabetic and nondiabetic patients after first acute myocardial infarction

• Published in: Chest Vol. 92; no. 5; p. 849
• Main Authors: Bhatnagar, S K, Al-Yusuf, A R, Al-Asfoor, A R
• Format: Journal Article
• Language: English
• Published: United States 01-11-1987
• Subjects: Adult; Autonomic Nervous System - physiopathology; Diabetic Neuropathies - complications; Diabetic Neuropathies - physiopathology; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - mortality; Posture; Prospective Studies; Respiration; Sympathetic Nervous System - physiopathology
• ISSN: 0012-3692
• DOI: 10.1378/chest.92.5.849

We performed autonomic function testing in 68 patients, 34 with diabetes mellitus (group A) and 34 without (group B), at 72 h after a first acute myocardial infarction (MI) to determine the prevalence of autonomic dysfunction in these patients. Heart rate (HR) variation during 6 breaths/min obtained from mean of longest RR interval during expiration(E)/mean of shortest RR interval during inspiration (I) (E:I ratio), immediate HR response to standing = RR at 30th beat/RR at 15th beat (30:15 ratio) and postural fall of blood pressure were evaluated. In group A, 25 (78 percent) of 32 patients had an abnormal expiration-inspiration ratio compared with 28 (85 percent) of 33 in group B. Twenty-six (76 percent) patients in group A and 16 (47 percent) in group B had an abnormal 30:15 ratio. Abnormal postural fall of blood pressure was seen in 16 (47 percent) patients in group A compared with ten (29 percent) in group B. During follow-up, four women in group A with an initial autonomic dysfunction died, and in group B, three patients with a normal autonomic function died. Thus, autonomic dysfunction does not seem to contribute to the high mortality among diabetics after an acute MI.