PMID- 31004672
OWN - NLM
STAT- MEDLINE
DCOM- 20190813
LR  - 20190813
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 151
DP  - 2019 May
TI  - Cardiac syncope recurrence in type 2 diabetes mellitus patients vs. 
      normoglycemics patients: The CARVAS study.
PG  - 152-162
LID - S0168-8227(19)30257-8 [pii]
LID - 10.1016/j.diabres.2019.04.015 [doi]
AB  - STUDY HYPOTHESIS: Cardiac autonomic dysfunction might lead to higher vaso vagal 
      syncope (VVS) recurrence rate in type 2 diabetes mellitus (T2DM) patients vs. non 
      diabetics patients. BACKGROUND: VVS recurrence might be due to alterations of 
      autonomic system function, as assessed by heart rate variability (HRV). To date, 
      in this study we investigated the correlation between HRV alterations and VVS 
      recurrence at 12 months of follow up in T2DM vs. non T2DM patients. MATERIALS AND 
      METHODS: In a prospective multicenter study we studied a propensity score 
      matching (PSM) analysis of 121 T2DM vs. 121 non T2DM patients affected by VVS. 
      RESULTS: T2DM vs. non T2DM patients had at baseline a higher rate of HRV 
      dysfunction, and this was linked to higher rate of VVS recurrence at 12 months of 
      follow up (p < 0.05). Blood pressure alterations and lower LF/HF ratio were 
      linked to higher rate of all cause syncope recurrence, and of vasodepressor, 
      cardio inhibitory, and mixed syncope recurrence (p < 0.05). Anti hypertensive 
      drug therapies increased the number of vasodepressor and mixed syncope events 
      (p < 0.05); alterations of heart rate increased syncope recurrence and mixed 
      syncope recurrence events (p < 0.05). Finally, T2DM was linked to higher rate of 
      VVS recurrence, and specifically of vasodepressor and mixed VVS recurrence 
      (p < 0.05). CONCLUSIONS: T2DM patients have alterations of the autonomic nervous 
      system, as result of cardiac autonomic neuropathy. However, T2DM diagnosis and 
      autonomic dysfunction assessed by HRV alterations predicted VVS recurrence.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Sardu, Celestino
AU  - Sardu C
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: drsarducele@gmail.com.
FAU - Paolisso, Pasquale
AU  - Paolisso P
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy.
FAU - Santamaria, Matteo
AU  - Santamaria M
AD  - Cardiovascular and Arrhythmias Department, Juan Paul II Research and Care 
      Foundation, Campobasso, Italy. Electronic address: matteo.santamaria@fgps.it.
FAU - Sacra, Cosimo
AU  - Sacra C
AD  - Cardiovascular and Arrhythmias Department, Juan Paul II Research and Care 
      Foundation, Campobasso, Italy. Electronic address: cosimo.sacra@fgps.it.
FAU - Pieretti, Gorizio
AU  - Pieretti G
AD  - Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 
      Naples, Italy. Electronic address: gorizio.pieretti@unicampania.it.
FAU - Rizzo, Maria Rosaria
AU  - Rizzo MR
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: 
      mariarosaria.rizzo@unicampania.it.
FAU - Barbieri, Michelangela
AU  - Barbieri M
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: 
      michelangela.barbieri@unicampania.it.
FAU - Scisciola, Lucia
AU  - Scisciola L
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: 
      lucia.scisciola@unicampania.it.
FAU - Nicoletti, Gianfranco
AU  - Nicoletti G
AD  - Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 
      Naples, Italy. Electronic address: Gianfranco.nicoletti@unicampania.it.
FAU - Paolisso, Giuseppe
AU  - Paolisso G
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: 
      giuseppe.paolisso@unicampania.it.
FAU - Marfella, Raffaele
AU  - Marfella R
AD  - Department of Advanced Medical and Surgical Sciences, University of Campania 
      "Luigi Vanvitelli", Naples, Italy. Electronic address: 
      raffaele.marfella@unicampania.it.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20190418
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
MH  - Diabetes Mellitus, Type 2/*complications/pathology
MH  - Female
MH  - Heart Diseases/*complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Syncope, Vasovagal/*etiology/pathology
MH  - Tilt-Table Test/*methods
OTO - NOTNLM
OT  - Cardiac autonomic dysfunction
OT  - Type 2 diabetes mellitus
OT  - Vaso vagal syncope
EDAT- 2019/04/21 06:00
MHDA- 2019/08/14 06:00
CRDT- 2019/04/21 06:00
PHST- 2019/02/19 00:00 [received]
PHST- 2019/04/01 00:00 [revised]
PHST- 2019/04/12 00:00 [accepted]
PHST- 2019/04/21 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
PHST- 2019/04/21 06:00 [entrez]
AID - S0168-8227(19)30257-8 [pii]
AID - 10.1016/j.diabres.2019.04.015 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2019 May;151:152-162. doi: 
      10.1016/j.diabres.2019.04.015. Epub 2019 Apr 18.