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Abstract: PO2266

Association Between Cardiac Autonomic Function and Coronary Artery Calcification in Persons with Type 2 Diabetes with and Without CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Sivalingam, Suvanjaa, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hein Zobel, Emilie, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hansen, Christian Stevns, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Ripa, Rasmus S., Kobenhavns Universitet, Kobenhavn, Denmark
  • Von Scholten, Bernt Johan, Novo Nordisk AS, Bagsvaerd, Denmark
  • Rotbain Curovic, Viktor, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Hansen, Tine, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Group or Team Name

  • Complications reseach
Background

Cardiac autonomic neuropathy and cardiovascular disease are concomitant complications to diabetes but the link between these complications are largely unknown, especially in relation to kidney function. We examined the association between measures of cardiac autonomic function and coronary artery calcification (CACS) in persons with type 2 diabetes stratified by presence of chronic kidney disease (CKD).

Methods

Post-hoc analysis of baseline data from a randomized clinical trial including 84 persons with type 2 diabetes.
Cardiac autonomic function was evaluated using heart rate variability (HRV) indices and cardiovascular autonomic reflex tests (CARTs). Lower response in CARTs and HRV measures were taken as indicators of impaired cardiac autonomic function. CT based CACS was calculated using Agatston method.

Results

The participants had a mean age of 64.7 (SD 7.8) years, 15% were women, mean eGFR was 83.5 (SD 16.2) ml/min/1.73 m2, median urinary albumin creatinine ratio 5.5 [IQR 3.5 – 11.8] mg/g and 10 (11.5%) had CKD (eGFR < 60 ml/min/1.73 m2).
In persons without CKD, a higher CACS was associated with a lower 30-to-15 ratio (-1.27, SE: 0.33), p < 0.0001), E-to-I ratio (-1.33, SE:0.32, p < 0.0001), standard deviation of normal-to-normal intervals (-0.73 ms, SE:0.34, p=0.03), high frequency power (-0.49 ms2, SE:0.24, p=0.045) and total power (-0.86 ms2, SE:0.33, p=0.01).
All these associations remained significant after adjustment for age, heart rate (only for HRV measures), sex, LDL-cholesterol, HbA1c, systolic blood pressure, diabetes duration and weight (except for standard deviation of normal-to-normal intervals and high frequency power).
In persons with CKD, no significant associations were demonstrated between measures of cardiac autonomic neuropathy and CACS.

Conclusion

In persons with type 2 diabetes but without CKD, we demonstrated an association between impaired cardiac autonomic function and higher coronary artery calcification. This association could not be demonstrated in persons with CKD.