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Sex‐specific effects of type 2 diabetes on autonomic function in coronary artery disease
Author(s) -
Kiviniemi Antti,
Hautala Arto J,
Karjalainen Jaana,
Piira Olli-Pekka,
Lepojärvi Samuli,
Tiinanen Suvi,
Seppänen Tapio,
Ukkola Olavi,
Huikuri Heikki V,
Tulppo Mikko P
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.684.4
Subject(s) - medicine , coronary artery disease , cardiology , ejection fraction , supine position , type 2 diabetes , baroreflex , blood pressure , diastole , body mass index , myocardial infarction , diabetes mellitus , heart rate , endocrinology , heart failure
Autonomic dysfunction is a potent factor increasing cardiac mortality in patients with coronary artery disease (CAD). However, the interaction of sex and type 2 diabetes (T2D) with autonomic function in CAD patients is not well‐known at modern treatment era. Spectral characteristics of R‐R interval and blood pressure (BP) oscillations and baroreflex sensitivity (BRS) were analyzed at supine rest and during passive tilt in 133 CAD patients with preserved ejection fraction (102 men, 52 T2D; 31 women, 14 T2D). The groups were matched according to age, ejection fraction and history of myocardial infarction. Sex*T2D interaction in response to tilt was assessed adjusting e.g. for exercise capacity, body mass index and CAD treatment. Sex*T2D interaction was observed in changes of diastolic BP (p=0.025) and BRS from rest to tilt (p=0.044). In women, decrease in diastolic BP was larger in CAD+T2D compared with CAD (−6±8 vs. 1±8 mmHg, p=0.022) but not in men (−3±7 vs. −3±8 mmHg, p=0.937). In women, decrease in BRS was larger in CAD+T2D compared with CAD (−1.3±3.6 vs. 1.5±8.5 ms/mmHg, p=0.024) but not in men (−3.2±3.2 vs. −2.8±5.9 ms/mmHg, p=0.488). Sex modifies the effects of T2D on autonomic responses to postural stress in CAD patients. TD2 impairs BP regulation particularly in CAD women. Supported by TEKES, Finland and Paavo Nurmi Foundation, Finland.