Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction

Dario Pitocco, Pasquale Santangeli, Leonello Fuso, Francesco Zaccardi, Anna Longobardi, Fabio Infusino, Raffaele Antonelli Incalzi, Gaetano Antonio Lanza, Filippo Crea, Giovanni Ghirlanda

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

BACKGROUND: In Type 1 diabetes mellitus (DM), it has been suggested that autonomic nervous system dysfunction (NAD) impairs lung diffusion capacity. Heart rate variability (HRV), a measure of cardiac autonomic function, is a sensitive method of detecting NAD. To our knowledge, no previous study has assessed whether cardiac sympatho-vagal balance is associated with lung diffusion capacity in diabetes. METHODS: Twenty Type 1 DM patients without pulmonary abnormalities and systemic NAD underwent measurement of lung diffusion capacity for carbon monoxide (DLCO) by single-breath method and assessment of cardiac autonomic function by HRV analysis on 24-h electrocardiographic Holter recordings. RESULTS: Standard respiratory function tests and peripheral autonomic tests were normal in all patients. DLCO was lower than normal reference values in six patients (30%). DLCO correlated significantly with most HRV variables, independent of the clinical and laboratory variables. The strongest correlation was found with standard deviation of all RR intervals (SDNN; r = 0.62, P = 0.003) in the time domain and low frequency (LF) power (r = 0.73, P < 0.001) in the frequency domain. CONCLUSIONS: In Type 1 diabetes, a significant association exists between cardiac NAD and reduced DLCO in the absence of clinical respiratory and autonomic abnormalities. Thus, NAD may be involved in the early reduction of DLCO in these patients, possibly through abnormalities in the regulation of pulmonary blood flow at the microvascular level.
Original languageEnglish
Pages (from-to)1366-1369
Number of pages4
JournalDiabetic Medicine
DOIs
Publication statusPublished - 2008

Keywords

  • Type 1 Diabetes

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