Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications

Bibliographic Details
Main Author: Duque, Alice
Publication Date: 2021
Other Authors: Mediano, Mauro Felippe Felix, Lorenzo, Andrea, Rodrigues Jr, Luiz Fernando
Format: Article
Language: eng
Source: Repositório Institucional da FIOCRUZ (ARCA)
DOI: 10.4239/wjd.v12.i6.855
Download full: https://arca.fiocruz.br/handle/icict/50557
Summary: Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.
id CRUZ_fd9265d24ff31c0da2ced272d0b40c7d
oai_identifier_str oai:arca.fiocruz.br:icict/50557
network_acronym_str CRUZ
network_name_str Repositório Institucional da FIOCRUZ (ARCA)
repository_id_str 2135
spelling Duque, AliceMediano, Mauro Felippe FelixLorenzo, AndreaRodrigues Jr, Luiz Fernando2021-12-29T13:49:06Z2021-12-29T13:49:06Z2021DUQUE, Alice et al. Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications. World journal of diabetes, v. 12, n. 6, p. 855-867, 20211948-9358https://arca.fiocruz.br/handle/icict/5055710.4239/wjd.v12.i6.855engBaishideng Publishing GroupCardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implicationsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.Cardiovascular autonomic neuropathy (CAN) is a debilitating condition that mainly occurs in long-standing type 2 diabetes patients but can manifest earlier, even before diabetes is diagnosed. CAN is a microvascular complication that results from lesions of the sympathetic and parasympathetic nerve fibers, which innervate the heart and blood vessels and promote alterations in cardiovascular autonomic control. The entire mechanism is still not elucidated, but several aspects of the pathophysiology of CAN have already been described, such as the production of advanced glycation end products, reactive oxygen species, nuclear factor kappa B, and pro-inflammatory cytokines. This microvascular complication is an important risk factor for silent myocardial ischemia, chronic kidney disease, myocardial dysfunction, major cardiovascular events, cardiac arrhythmias, and sudden death. It has also been suggested that, compared to other traditional cardiovascular risk factors, CAN progression may have a greater impact on cardiovascular disease development. However, CAN might be subclinical for several years, and a late diagnosis increases the mortality risk. The duration of the transition period from the subclinical to clinical stage remains unknown, but the progression of CAN is associated with a poor prognosis. Several tests can be used for CAN diagnosis, such as heart rate variability (HRV), cardiovascular autonomic reflex tests, and myocardial scintigraphy. Currently, it has already been described that CAN could be detected even during the subclinical stage through a reduction in HRV, which is a non-invasive test with a lower operating cost. Therefore, considering that diabetes mellitus is a global epidemic and that diabetic neuropathy is the most common chronic complication of diabetes, the early identification and treatment of CAN could be a key point to mitigate the morbidity and mortality associated with this long-lasting condition.Cardiac autonomic neuropathyCardiovascular autonomic neuropathyDiabetes mellitusHeart rate variabilityParasympathetic autonomic nervous systemSympathetic autonomic nervous systeminfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://arca.fiocruz.br/bitstreams/628d3b61-2cbb-4e34-ad77-f03163a5bb08/download586c046dcfeef936e32f0323bb9a47c0MD51falseAnonymousREADORIGINALCardiovascular_Mauro_Mediano_etal_INI_2021.pdfCardiovascular_Mauro_Mediano_etal_INI_2021.pdfapplication/pdf482564https://arca.fiocruz.br/bitstreams/3ccb77f8-f023-4175-bb68-89123af5e13b/download38c04cf8d1321210520754a682d90723MD52trueAnonymousREADTEXTCardiovascular_Mauro_Mediano_etal_INI_2021.pdf.txtCardiovascular_Mauro_Mediano_etal_INI_2021.pdf.txtExtracted texttext/plain71222https://arca.fiocruz.br/bitstreams/c8934b9c-e132-418f-8cf1-4becf663a2fc/download01bb54d6562edf48e030713dc643098fMD55falseAnonymousREADTHUMBNAILCardiovascular_Mauro_Mediano_etal_INI_2021.pdf.jpgCardiovascular_Mauro_Mediano_etal_INI_2021.pdf.jpgGenerated Thumbnailimage/jpeg6427https://arca.fiocruz.br/bitstreams/9d5ffeac-5438-4548-a03e-64262a6760b0/download63a51a95cda4f204df3b8e60331725e6MD56falseAnonymousREADicict/505572025-07-30 02:44:13.274open.accessoai:arca.fiocruz.br:icict/50557https://arca.fiocruz.brRepositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352025-07-30T05:44:13Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)falseQ0VTU8ODTyBOw4NPIEVYQ0xVU0lWQSBERSBESVJFSVRPUyBBVVRPUkFJUw0KDQpGw6FiaW8gTWFycXVlcywgQ1BGOiAxMTMuMTg3Ljg1Ny00MCwgdmluY3VsYWRvIGEgSU5JIC0gSW5zdGl0dXRvIE5hY2lvbmFsIGRlIEluZmVjdG9sb2dpYSBFdmFuZHJvIENoYWdhcwoKQW8gYWNlaXRhciBvcyBURVJNT1MgZSBDT05EScOHw5VFUyBkZXN0YSBDRVNTw4NPLCBvIEFVVE9SIGUvb3UgVElUVUxBUiBkZSBkaXJlaXRvcwphdXRvcmFpcyBzb2JyZSBhIE9CUkEgZGUgcXVlIHRyYXRhIGVzdGUgZG9jdW1lbnRvOgoKKDEpIENFREUgZSBUUkFOU0ZFUkUsIHRvdGFsIGUgZ3JhdHVpdGFtZW50ZSwgw6AgRklPQ1JVWiAtIEZVTkRBw4fDg08gT1NXQUxETyBDUlVaLCBlbQpjYXLDoXRlciBwZXJtYW5lbnRlLCBpcnJldm9nw6F2ZWwgZSBOw4NPIEVYQ0xVU0lWTywgdG9kb3Mgb3MgZGlyZWl0b3MgcGF0cmltb25pYWlzIE7Dg08KQ09NRVJDSUFJUyBkZSB1dGlsaXphw6fDo28gZGEgT0JSQSBhcnTDrXN0aWNhIGUvb3UgY2llbnTDrWZpY2EgaW5kaWNhZGEgYWNpbWEsIGluY2x1c2l2ZSBvcyBkaXJlaXRvcwpkZSB2b3ogZSBpbWFnZW0gdmluY3VsYWRvcyDDoCBPQlJBLCBkdXJhbnRlIHRvZG8gbyBwcmF6byBkZSBkdXJhw6fDo28gZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCBlbQpxdWFscXVlciBpZGlvbWEgZSBlbSB0b2RvcyBvcyBwYcOtc2VzOwoKKDIpIEFDRUlUQSBxdWUgYSBjZXNzw6NvIHRvdGFsIG7Do28gZXhjbHVzaXZhLCBwZXJtYW5lbnRlIGUgaXJyZXZvZ8OhdmVsIGRvcyBkaXJlaXRvcyBhdXRvcmFpcwpwYXRyaW1vbmlhaXMgbsOjbyBjb21lcmNpYWlzIGRlIHV0aWxpemHDp8OjbyBkZSBxdWUgdHJhdGEgZXN0ZSBkb2N1bWVudG8gaW5jbHVpLCBleGVtcGxpZmljYXRpdmFtZW50ZSwKb3MgZGlyZWl0b3MgZGUgZGlzcG9uaWJpbGl6YcOnw6NvIGUgY29tdW5pY2HDp8OjbyBww7pibGljYSBkYSBPQlJBLCBlbSBxdWFscXVlciBtZWlvIG91IHZlw61jdWxvLAppbmNsdXNpdmUgZW0gUmVwb3NpdMOzcmlvcyBEaWdpdGFpcywgYmVtIGNvbW8gb3MgZGlyZWl0b3MgZGUgcmVwcm9kdcOnw6NvLCBleGliacOnw6NvLCBleGVjdcOnw6NvLApkZWNsYW1hw6fDo28sIHJlY2l0YcOnw6NvLCBleHBvc2nDp8OjbywgYXJxdWl2YW1lbnRvLCBpbmNsdXPDo28gZW0gYmFuY28gZGUgZGFkb3MsIHByZXNlcnZhw6fDo28sIGRpZnVzw6NvLApkaXN0cmlidWnDp8OjbywgZGl2dWxnYcOnw6NvLCBlbXByw6lzdGltbywgdHJhZHXDp8OjbywgZHVibGFnZW0sIGxlZ2VuZGFnZW0sIGluY2x1c8OjbyBlbSBub3ZhcyBvYnJhcyBvdQpjb2xldMOibmVhcywgcmV1dGlsaXphw6fDo28sIGVkacOnw6NvLCBwcm9kdcOnw6NvIGRlIG1hdGVyaWFsIGRpZMOhdGljbyBlIGN1cnNvcyBvdSBxdWFscXVlciBmb3JtYSBkZQp1dGlsaXphw6fDo28gbsOjbyBjb21lcmNpYWw7CgooMykgUkVDT05IRUNFIHF1ZSBhIGNlc3PDo28gYXF1aSBlc3BlY2lmaWNhZGEgY29uY2VkZSDDoCBGSU9DUlVaIC0gRlVOREHDh8ODTyBPU1dBTERPCkNSVVogbyBkaXJlaXRvIGRlIGF1dG9yaXphciBxdWFscXVlciBwZXNzb2Eg4oCTIGbDrXNpY2Egb3UganVyw61kaWNhLCBww7pibGljYSBvdSBwcml2YWRhLCBuYWNpb25hbCBvdQplc3RyYW5nZWlyYSDigJMgYSBhY2Vzc2FyIGUgdXRpbGl6YXIgYW1wbGFtZW50ZSBhIE9CUkEsIHNlbSBleGNsdXNpdmlkYWRlLCBwYXJhIHF1YWlzcXVlcgpmaW5hbGlkYWRlcyBuw6NvIGNvbWVyY2lhaXM7CgooNCkgREVDTEFSQSBxdWUgYSBvYnJhIMOpIGNyaWHDp8OjbyBvcmlnaW5hbCBlIHF1ZSDDqSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGFxdWkgY2VkaWRvcyBlIGF1dG9yaXphZG9zLApyZXNwb25zYWJpbGl6YW5kby1zZSBpbnRlZ3JhbG1lbnRlIHBlbG8gY29udGXDumRvIGUgb3V0cm9zIGVsZW1lbnRvcyBxdWUgZmF6ZW0gcGFydGUgZGEgT0JSQSwKaW5jbHVzaXZlIG9zIGRpcmVpdG9zIGRlIHZveiBlIGltYWdlbSB2aW5jdWxhZG9zIMOgIE9CUkEsIG9icmlnYW5kby1zZSBhIGluZGVuaXphciB0ZXJjZWlyb3MgcG9yCmRhbm9zLCBiZW0gY29tbyBpbmRlbml6YXIgZSByZXNzYXJjaXIgYSBGSU9DUlVaIC0gRlVOREHDh8ODTyBPU1dBTERPIENSVVogZGUKZXZlbnR1YWlzIGRlc3Blc2FzIHF1ZSB2aWVyZW0gYSBzdXBvcnRhciwgZW0gcmF6w6NvIGRlIHF1YWxxdWVyIG9mZW5zYSBhIGRpcmVpdG9zIGF1dG9yYWlzIG91CmRpcmVpdG9zIGRlIHZveiBvdSBpbWFnZW0sIHByaW5jaXBhbG1lbnRlIG5vIHF1ZSBkaXogcmVzcGVpdG8gYSBwbMOhZ2lvIGUgdmlvbGHDp8O1ZXMgZGUgZGlyZWl0b3M7CgooNSkgQUZJUk1BIHF1ZSBjb25oZWNlIGEgUG9sw610aWNhIEluc3RpdHVjaW9uYWwgZGUgQWNlc3NvIEFiZXJ0byBkYSBGSU9DUlVaIC0gRlVOREHDh8ODTwpPU1dBTERPIENSVVogZSBhcyBkaXJldHJpemVzIHBhcmEgbyBmdW5jaW9uYW1lbnRvIGRvIHJlcG9zaXTDs3JpbyBpbnN0aXR1Y2lvbmFsIEFSQ0EuCgpBIFBvbMOtdGljYSBJbnN0aXR1Y2lvbmFsIGRlIEFjZXNzbyBBYmVydG8gZGEgRklPQ1JVWiAtIEZVTkRBw4fDg08gT1NXQUxETyBDUlVaIHJlc2VydmEKZXhjbHVzaXZhbWVudGUgYW8gQVVUT1Igb3MgZGlyZWl0b3MgbW9yYWlzIGUgb3MgdXNvcyBjb21lcmNpYWlzIHNvYnJlIGFzIG9icmFzIGRlIHN1YSBhdXRvcmlhCmUvb3UgdGl0dWxhcmlkYWRlLCBzZW5kbyBvcyB0ZXJjZWlyb3MgdXN1w6FyaW9zIHJlc3BvbnPDoXZlaXMgcGVsYSBhdHJpYnVpw6fDo28gZGUgYXV0b3JpYSBlIG1hbnV0ZW7Dp8OjbwpkYSBpbnRlZ3JpZGFkZSBkYSBPQlJBIGVtIHF1YWxxdWVyIHV0aWxpemHDp8Ojby4KCkEgUG9sw610aWNhIEluc3RpdHVjaW9uYWwgZGUgQWNlc3NvIEFiZXJ0byBkYSBGSU9DUlVaIC0gRlVOREHDh8ODTyBPU1dBTERPIENSVVoKcmVzcGVpdGEgb3MgY29udHJhdG9zIGUgYWNvcmRvcyBwcmVleGlzdGVudGVzIGRvcyBBdXRvcmVzIGNvbSB0ZXJjZWlyb3MsIGNhYmVuZG8gYW9zIEF1dG9yZXMKaW5mb3JtYXIgw6AgSW5zdGl0dWnDp8OjbyBhcyBjb25kacOnw7VlcyBlIG91dHJhcyByZXN0cmnDp8O1ZXMgaW1wb3N0YXMgcG9yIGVzdGVzIGluc3RydW1lbnRvcy4K
dc.title.none.fl_str_mv Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
title Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
spellingShingle Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
Duque, Alice
Cardiac autonomic neuropathy
Cardiovascular autonomic neuropathy
Diabetes mellitus
Heart rate variability
Parasympathetic autonomic nervous system
Sympathetic autonomic nervous system
title_short Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
title_full Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
title_fullStr Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
title_full_unstemmed Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
title_sort Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
author Duque, Alice
author_facet Duque, Alice
Mediano, Mauro Felippe Felix
Lorenzo, Andrea
Rodrigues Jr, Luiz Fernando
author_role author
author2 Mediano, Mauro Felippe Felix
Lorenzo, Andrea
Rodrigues Jr, Luiz Fernando
author2_role author
author
author
dc.contributor.author.fl_str_mv Duque, Alice
Mediano, Mauro Felippe Felix
Lorenzo, Andrea
Rodrigues Jr, Luiz Fernando
dc.subject.en.none.fl_str_mv Cardiac autonomic neuropathy
Cardiovascular autonomic neuropathy
Diabetes mellitus
Heart rate variability
Parasympathetic autonomic nervous system
Sympathetic autonomic nervous system
topic Cardiac autonomic neuropathy
Cardiovascular autonomic neuropathy
Diabetes mellitus
Heart rate variability
Parasympathetic autonomic nervous system
Sympathetic autonomic nervous system
description Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil.
publishDate 2021
dc.date.accessioned.fl_str_mv 2021-12-29T13:49:06Z
dc.date.available.fl_str_mv 2021-12-29T13:49:06Z
dc.date.issued.fl_str_mv 2021
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv DUQUE, Alice et al. Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications. World journal of diabetes, v. 12, n. 6, p. 855-867, 2021
dc.identifier.uri.fl_str_mv https://arca.fiocruz.br/handle/icict/50557
dc.identifier.issn.none.fl_str_mv 1948-9358
dc.identifier.doi.none.fl_str_mv 10.4239/wjd.v12.i6.855
identifier_str_mv DUQUE, Alice et al. Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications. World journal of diabetes, v. 12, n. 6, p. 855-867, 2021
1948-9358
10.4239/wjd.v12.i6.855
url https://arca.fiocruz.br/handle/icict/50557
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Baishideng Publishing Group
publisher.none.fl_str_mv Baishideng Publishing Group
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://arca.fiocruz.br/bitstreams/628d3b61-2cbb-4e34-ad77-f03163a5bb08/download
https://arca.fiocruz.br/bitstreams/3ccb77f8-f023-4175-bb68-89123af5e13b/download
https://arca.fiocruz.br/bitstreams/c8934b9c-e132-418f-8cf1-4becf663a2fc/download
https://arca.fiocruz.br/bitstreams/9d5ffeac-5438-4548-a03e-64262a6760b0/download
bitstream.checksum.fl_str_mv 586c046dcfeef936e32f0323bb9a47c0
38c04cf8d1321210520754a682d90723
01bb54d6562edf48e030713dc643098f
63a51a95cda4f204df3b8e60331725e6
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1839716478224433152

Similar Items