Reliability of heart rate variability in patients with Type 2 diabetes mellitus

Diabet. Med. 29, e33–e40 (2012) Aims  Heart rate variability may be used to assess diabetic cardiac autonomic neuropathy. The aim of the present study was to determine the reliability of standard short‐term clinical measurements of heart rate variability in patients with Type 2 diabetes. Methods  In...

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Bibliographic Details
Published in:Diabetic medicine 2012-07, Vol.29 (7), p.e33-e40
Main Authors: Sacre, J. W., Jellis, C. L., Marwick, T. H., Coombes, J. S.
Format: Article
Language:English
Subjects:
Aged
Analysis of Variance
Data Interpretation, Statistical
Diabetes
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - physiopathology
diabetic autonomic neuropathy
Diabetic Neuropathies - blood
Diabetic Neuropathies - etiology
Diabetic Neuropathies - physiopathology
Electrocardiography - methods
Female
Heart Rate
heart rate variability
Humans
Male
Middle Aged
Reproducibility of Results
sample size
Time Factors
Type 2 diabetes mellitus
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Summary:Diabet. Med. 29, e33–e40 (2012) Aims  Heart rate variability may be used to assess diabetic cardiac autonomic neuropathy. The aim of the present study was to determine the reliability of standard short‐term clinical measurements of heart rate variability in patients with Type 2 diabetes. Methods  In 24 patients with Type 2 diabetes (11 male, age 61 ± 9 years), parameters of heart rate variability in the time domain (standard deviation of RR intervals, coefficient of variation of RR intervals and root mean square of successive RR interval differences) and frequency domain (very low frequency, low frequency, high frequency and total spectral power) were derived from a 5‐min electrocardiograph recorded during two laboratory visits separated by 16 ± 8 days. Absolute and relative reliability were assessed by 95% limits of random variation and the intraclass correlation coefficient, respectively. Categorical agreement of classifications of heart rate variability and sample size estimates for clinical trials were calculated. Results  Despite no significant difference in mean heart rate variability between tests, 95% limits of random variation indicated that repeated measurements were between 58% higher/37% lower (most reliable parameter; coefficient of variation of RR intervals) and 443% higher/82% lower (least reliable parameter; very low frequency power) than the first measure. The intraclass correlation coefficient ranged from 0.58 to 0.90 and sample size requirements from 20 to 93 patients per group. Agreement of categories of heart rate variability ranged from 79 to 96%. Conclusions  Short‐term clinical measurements of heart rate variability in patients with Type 2 diabetes are characterized by poor absolute reliability, but substantial to good relative reliability, suggesting greater clinical utility in diagnosis than in sequential follow‐up.
ISSN:0742-3071
1464-5491
DOI:10.1111/j.1464-5491.2011.03557.x