Heart rate fragmentation and its relationship with cardiovascular control in type 2 diabetes with cardiovascular autonomic neuropathy

Cardiovascular autonomic neuropathy (CAN) alters cardiovascular autonomic control in type 2 diabetes (T2DM). We evaluated the heart rate fragmentation (HRF) in T2DM with and without CAN and relate it to heart period (HP) and systolic arterial pressure (SAP). HP and SAP series were collected in T2DM with CAN (n = 28) and without CAN (n=36) at supine and during active standing for 15 min. The number of words with n inflection points (W n), the percentage of inflection points (PIP), and the coherence (K2 HP-SAP ) at low frequency (LF) and high frequency (HF) were quantified. T2DM with CAN showed higher W3 in supine with an increase during STAND. At REST, PIP, W1 and W3 were linearly correlated with K2 HP-SAP at HF. During STAND, PIP was linearly correlated with K2 HP-SAP at LF. CAN increases HRF and a higher HRF was associated with a lower K2 HP-sap indicating a less efficient baroreflex especially during STAND.