Introduction. Cardiovascular autonomic neuropathy (CAN) is a significant risk factor for cardiovascular morbidity and mortality in patients with diabetes mellitus. However, an association between CAN and severity of coronary atherosclerosis in patients with coronary heart disease (CHD) was not investigated.
Objectives. The aim of this study was to investigate the relationship of CAN and coronary stenosis in patients with clinical signs of CHD.
Materials and methods. We examined 63 patients, 48 men and 15 women with clinical symptoms of CHD (aged (61,79±1,18) years, BMI — (30,39±0,61) kg/m2) (data are presented everywhere as mean ± SEM). All patients were performed 5 standart tests to diagnose CAN by Ewing, coronaroventriculography, oral glucose tolerance test. The diagnosis of CAN was confirmed in patients with 3 positive tests. The data analysis by SPSS statistical package version 23.0 for Windows.
Results. CAN was diagnosed in 52.4% patients, diabetes mellitus type 2 was diagnosed in 15.9% patients. All patients were divided for 3 groups depending on the number of occluded coronary arteries — with lesions in 1, 2 or 3 arteries. We found negative correlation between the number of the coronary arteries with atherosclerotic lesions and impaired results of Valsalva maneuver reflecting parasympathetic dysfunction (OR=-0.23; p<0.05) and with the changes of diastolic blood pressure to isometric exercise (handgrip test) reflecting sympathetic dysfunction (OR=-0.2; p<0.05).
Conclusion. We found some relationship between the severity of coronary arteries stenosis and sympathetic and parasympathetic dysfunction in patients with CHD. These data can suggest the pathogenetic role of the impairment of cardiovascular autonomic regulation in the progression of atherosclerosis of coronary arteries.