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Cardiac baroreflex sensitivity in coronary patients with and without type 2 diabetes

      Background: Coronary artery disease (CAD) can promote impairments of cardiac autonomic nervous system. Nevertheless, when CAD is associated to other comorbidities, such as the type 2 diabetes mellitus (DM), is unknown the magnitude of impairments in baroreflex sensitivity (BRS). Aim: to evaluate the baroreflex sensitivity in CAD patients (CAD, n = 18), CAD patients with DM (CAD-DM, n = 16), and healthy group (H, n = 19). Methods: The recording of R-R interval (RR) of the ECG was performed in the MC5 lead and the non-invasive finger blood pressure were recorded during rest supine and standing, both for 15 minutes. Signals were sampled at 1000 Hz. The BRS α index was computed as the square root of the ratio of the power of RR series on that of systolic arterial pressure (SAP) series in the low frequency (0.04-0.15Hz). Two-way ANOVA test was used to compare BRS between the groups and conditions. Results: no difference in age and anthropometric date between the groups was observed. The α index decreased during standing (5.33 ± 2.72 vs 4.80 ± 3.34 vs 2.76 ± 1.44; H vs CAD vs CAD-DM) when compared to rest supine (10.55 ± 6.70 vs 7.74 ± 5.86 vs 6.10 ± 4.30; H vs CAD vs CAD-DM) in all groups. The CAD-DM group shows lower values of α index compared to H group in rest supine and standing positions. Conclusion: Although CAD groups had a normal response to the orthostatic stimuli, the CAD-DM group showed lower values of BRS in both conditions. Thus, a higher impairment of cardiovascular control can be observed in patients with type 2 diabetes. Financial support: CAPES/CSF/PVE no. 23038.007721/2013-41; CAPES/PNPD no. 23038.006927/2011-92; FAPESP no. 2010/52070-4 e CNPq no. 311938/2013-2
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