Kardiale autonome diabetische Neuropathie

ZUSAMMENFASSUNG

Die kardiale autonome diabetische Neuropathie (KADN) geht mit einer erhöhten Mortalität und Morbidität einher. Sie kommt auch in frühen Phasen der Entwicklung eines Diabetes mellitus vor. Die KADN ist unterdiagnostiziert, unter anderem weil die Screening-Tests zeitaufwändig und kostspielig sind, aber auch weil unsere Wahrnehmung hinsichtlich der Bedeutung der KADN unzureichend ausgeprägt ist. Dieser Artikel beschäftigt sich mit der Epidemiologie, der prognostischen Relevanz, Diagnostik, sowie Therapie der KADN.

• Literatur

• 1 Dimitropoulos G, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus. World J Diabetes 2014; 05: 17-39
• 2 Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation 2007; 115: 387-97
• 3 Ziegler D, Keller J. et al Diabetische Neuropathie. Diabetologie 2020; 15 (Suppl. 01) S181-S195
• 4 Chowdhury M, Nevitt S, Eleftheriadou A. et al Cardiac autonomic neuropathy and risk of cardiovascular disease and mortality in type 1 and type 2 diabetes: a meta-analysis. BMJ Open Diab Res Care 2021; 09: e002480
• 5 Balcıoğlu AS, Müderrisoğlu H. Diabetes and cardiac autonomic neuropathy: clinical manifestations, cardiovascular consequences, diagnosis and treatment. World J Diabetes 2015; 06: 80-91
• 6 Piya MK, Shivu GN, Tahrani A. et al Abnormal left ventricular torsion and cardiac autonomic dysfunction in subjects with type 1 diabetes mellitus. Metabolism 2011; 60: 1115-1121
• 7 Pop-Busui R. Cardiac autonomic neuropathy in diabetes: a clinical perspective. Diabetes Care 2010; 33: 434-441
• 8 Basra R, Papanas N, Farrow F. et al Diabetic Foot Ulcers and Cardiac Autonomic Neuropathy. Clin Ther 2022; 44: 323-330
• 9 Spallone V, Ziegler D, Freeman R. et al Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis and management. Diabetes Metab Res Rev 2011; 27: 639-653
• 10 Pop-Busui R, Backlund JY, Bebu I. et al Utility of using electrocardiogram measures of heart rate variability as a measure of cardiovascular autonomic neuropathy in type 1 diabetes patients. J Diabetes Investig 2022; 13: 125-133
• 11 https://www.deutsche-diabetes-gesellschaft.de/fileadmin/user_upload/05_Behandlung/01_Leitlinien/Praxisempfehlungen/2020/dus_2020_S01_Praxisempfehlungen_Neuropathie_Ziegler.pdf (letzter Zugriff: 20.06.2022)
• 12 Hazarika K, Devee A, Chaliha Ms, Sarmah B. Cardiac Autonomic Neuropathy in Newly Diagnosed Type-2 Diabetes Mellitus Patients with Special Reference to Left Ventricular Diastolic Dysfunction. J Assoc Physicians India 2022; 70: 11-12
• 13 Rasmussen VF, Jensen TS, Tankisi H. et al Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review. J Diabetes Complications 2021; 35: 108027
• 14 Bjerre-Christensen T, Winther SA, Tofte N. et al Cardiovascular autonomic neuropathy and the impact on progression of diabetic kidney disease in type 1 diabetes. BMJ Open Diab Res Care 2021; 09: e002289
• 15 Hogan D, Lurbe E, Salabat MR. et al Circadian changes in blood pressure and their relationships to the development of microalbuminuria in type 1 diabetic patients. Curr Diab Rep 2002; 02: 539-544
• 16 Pop-Busui R, Kirkwood I, Schmid H. et al Sympathetic dysfunction in type 1 diabetes. J Am Coll Cardiol 2004; 44: 2368-2374
• 17 O’Brien IA, McFadden JP, Corrall RJ. The influence of autonomic neuropathy on mortality in insulin-dependent diabetes. Q J Med 1991; 79: 495-502
• 18 Zobel EH, Winther SA, Hasbak P. et al Myocardial flow reserve assessed by cardiac 82Rb positron emission tomography/computed tomography is associated with albumin excretion in patients with type 1 diabetes. Eur Heart J Cardiovasc Imaging 2019; 20: 796-803
• 19 von Scholten BJ, Christensen TE, Christensen TE. et al Cardiac 82Rb PET/CT for fast and non-invasive assessment of microvascular function and structure in asymptomatic patients with type 2 diabetes. Diabetologia 2016; 59: 371-378
• 20 Pop-Busui R, Low PA, Waberski BH. et al Effects of prior intensive insulin therapy on cardiac autonomic nervous system function in type 1 diabetes mellitus: the diabetes control and complications Trial/Epidemiology of diabetes interventions and complications study (DCCT/EDIC). Circulation 2009; 119: 2886-2893
• 21 Martin CL, Albers JW, Pop-Busui R. DCCT/EDIC Research Group. Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care 2014; 37: 31-38
• 22 Gæde P, Oellgaard J, Carstensen B. et al Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial. Diabetologia 2016; 59: 2298-2307
• 23 Bönhof GJ, Strom A, Apostolopoulou M. et al High-intensity interval training for 12 weeks improves cardiovascular autonomic function but not somatosensory nerve function and structure in overweight men with type 2 diabetes. Diabetologia 2022; 65: 1048-1057
• 24 Aronson D.. Pharmacologic modulationof autonomic tone: implications for the diabetic patient. Diabetologia 1997; 40: 476-481
• 25 Ziegler D, Schatz H, Conrad F. et al Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Deutsche Kardiale Autonome Neuropathie. Diabetes Care 1997; 20: 369-373
• 26 Putz Z, Tordai D, Hajdú N. et al Vitamin D in the Prevention and Treatment of Diabetic Neuropathy. Clin Ther 2022; 12: S0149-2918 (22)00136-9
• 27 Greco C, Santi D, Brigante D. et al Effect of the Glucagon-Like Peptide-1 Receptor Agonists on Autonomic Function in Subjects with Diabetes: A Systematic Review and Meta-Analysis, Diabetes Metab J. 2022 Online ahead of print
• 28 Matthews VB, Elliot RH, Rudnicka C. et al Role of the sympathetic nervous system in regulation of the sodium glucose cotransporter 2. J Hypertens 2017; 35: 2059-2068
• 29 Freeman R. Clinical practice. Neuro-genic orthostatic hypotension. N Engl J Med 2008; 358: 615-624