Cardiovascular autonomic neuropathy in diabetes: Pathophysiology, clinical assessment and implications
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/50557 |
Resumo: | Instituto Nacional de Cardiologia. Departamento de Educação e Pesquisa. Rio de Janeiro, RJ, Brasil. |
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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://www.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; 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dc.title.pt_BR.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.pt_BR.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://www.arca.fiocruz.br/handle/icict/50557 |
dc.identifier.issn.pt_BR.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://www.arca.fiocruz.br/handle/icict/50557 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Baishideng Publishing Group |
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Baishideng Publishing Group |
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reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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