n acute coronary syndromes there is increasing speculation that autonomic dysfunction complicating diabetes may adversely affect outcomes. Mechanisms are unclear but the potential effects on the timing of plaque events, the mode of presentation, myocardial oxygen demand and arrhythmogenesis are discussed in this article.
Töyry JP, Niskanen LK, Mäntysaari MJ, Länsimies EA, Uusitupa MIJ.Occurrence, predictors, and clinical significance of autonomic neuropathy in NIDDM: ten-year follow-up from the diagnosis. Diabetes1996;45: 308-15.
2.
Jamerson KA, Julius S., Gudbrandsson T., Andersson O., Brant DOReflex sympathetic activation induces acute insulin resistance in the human forearm. Hypertension1993;21:618-23.
3.
Jamerson KA, Smith SD, Amerena JV, Grant E., Julius S.Vasoconstriction with norepinephrine causes less forearm insulin resistance than a reflex sympathetic vasoconstriction. Hypertension1994;23:1006-11.
4.
Huggett RJ, Scott EM, Gilbey SG, Stoker JB, Mackintosh AF, Mary DAImpact of type 2 diabetes mellitus on sympathetic neural mechanisms in hypertension . Circulation2003;108:3097-101.
5.
Brunner EJ, Hemingway H., Walker BR et al. Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study. Circulation2002;106:2659-65.
6.
Stone PH, Muller JE, Hartwell T. et al. The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. The MILIS Study Group. J Am Coll Cardiol1989;14:49-57.
7.
Granger CB, Califf RM, Young S. et al., and The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.Outcome of patients with diabetes mellitus and acute myocardial infarction treated with thrombolytic agents. J Am Coll Cardiol1993;21:920-5.
8.
Woodfield SL , Lundergan CF, Reiner JS et al. Angiographic findings and outcome in diabetic patients treated with thrombolytic therapy for acute myocardial infarction: the GUSTO-I experience. J Am Coll Cardiol1996;28:1661-9.
9.
Mak KH, Moliterno DJ, Granger CB et al. Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. GUSTO-I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries . J Am Coll Cardiol1997;30:171-9
10.
Robertson W. , Strong J.Atherosclerosis in persons with hypertension and diabetes mellitus. Lab Invest1968;18:538-51.
11.
Hamby R., Sherman L., Mehta J., Aintablian A.Reappraisal of the role of the diabetic state in coronary artery disease . Chest1976;70:251-7.
12.
Waller B., Palumbo B., Roberts W.Status of the coronary arteries at necropsy in diabetes mellitus with onset after age 30 years. Am J Med1980;69:498-506.
13.
Kass DA, Saeki A., Tunin RS, Recchia FAAdverse influence of systemic vascular stiffening on cardiac dysfunction and adaptation to acute coronary occlusion. Circulation1996;93:1533-41.
14.
Watanabe H. , Ohtsuka S., Kakihana M., Sugishita Y.Coronary circulation in dogs with an experimental decrease in aortic compliance. J Am Coll Cardiol1993;21:1497-506.
15.
Di Carli MF , Bianco-Batlles D., Landa ME, Kazmers A., Groehn H., Muzik O., Grunberger G.Effects of autonomic dysfunction on coronary blood flow in patients with diabetes mellitus . Circulation1999;100:813-19.
16.
Foo K., Sekhri N., Knight C., Deaner A., Ranjadayalan K., Cooper J., Timmis ADEffects of diabetes on heart rate and other determinants of myocardial oxygen demand in acute coronary syndromes. Diabet Med2004;21: 1025-31.
Heidland UE , Strauer BELeft ventricular muscle mass and elevated heart rate are associated with coronary plaque disruption. Circulation2001; 104:1477-82.
19.
Hjalmarson A., Gilpin EA, Kjekshus J. et al. Influence of heart rate on mortality after acute myocardial infarction. Am J Cardiol1990;65:547-53.
20.
Zuanetti G. , Mantini L., Hernandez-Bernal F. et al. Relevance of heart rate as a prognostic factor in patients with acute myocardial infarction: insights from the GISSI-2 study. Eur Heart J1998;19(suppl F):F19-F26.
21.
Copie X., Hnatkova K., Staunton A., Fei L., Camm AJ, Malik M.Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction. Results of a two-year follow-up study. J Am Coll Cardiol1996; 27:270-6.
22.
Malmberg K. , Herlitz J., Hjalmarson A., Ryden L.Effects of metoprolol on mortality and late infarction in diabetics with suspected acute myocardial infarction. Retrospective data from two large studies. Eur Heart J1989 ; 10:423-8.
23.
Muller JE, Stone PH, Turi ZG et al. Circadian variation in the frequency of onset of acute myocardial infarction. N Engl J Med1985;313:1315-22.
24.
Marchant B. , Ranjadayalan K., Stevenson R., Wilkinson P., Timmis ADCircadian and seasonal factors in the pathogenesis of acute myocardial infarction: the influence of environmental temperature . Br Heart J1993; 69:385-7.
25.
Sayer JW, Wilkinson P., Ranjadayalan K., Ray S., Marchant B., Timmis ADAttenuation or absence of circadian and seasonal rhythms of acute myocardial infarction. Br Heart J1997;77:325-9.
26.
Uretsky BF, Farquhar D., Berezin A., Hood W.Symptomatic myocardial infarction without chest pain: prevalence and clinical course. Am J Cardiol1977;40:498-503.
27.
Araz M., Celen Z., Akdemir I., Okan V.Frequency of silent myocardial ischemia in type 2 diabetic patients and the relation with poor glycemic control. Acta Diabetol2004;41:38-43.
28.
Marchant B. , Umachandran V., Stevenson R., Kopelman PG, Timmis ADSilent myocardial ischaemia: the role of subclinical dysfunction in patients with and without diabetes. J Am Coll Cardiol1993;22:1433-7.
29.
Ottesen MM, Kober L., Jorgensen S., Torp-Pedersen C., for the TRACE study group.Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. Europ Heart J1996;17:429-37.
30.
Barakat K., Wells Z., Ramdhany S., Mills PG, Timmis ADBangladeshi patients present with non-classical features of AMI and are treated less aggressively in the East End of London. Heart2003;89:276-9.
31.
Gerritsen J. , Dekker JM, TenVoorde BJ et al. Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease: the Hoorn Study. Diabetes Care2001 ;24:1793-8.
32.
Vaishnav S., Stevenson R., Marchant B., Ranjadayalan K., Timmis ADThe relation between heart rate variability early after acute myocardial infarction and long-term mortality. Am J Cardiol1994 ;73:653-7.
33.
Ewing DJ, Boland O., Neilson JMM, Cho CG, Clarke BFAutonomic dysfunction, QT lengthening, and unexpected deaths in male diabetic patients. Diabetologia1991;34:182-5.
34.
Bellavere F. , Ferri M., Guarini L. et al. Prolonged QT period in diabetic autonomic dysfunction: a possible role in sudden cardiac death. Br Heart J1988;59:379-83.
35.
Foo K., Sekhri N., Deaner A., Knight C., Ranjadayalan K., Timmis ADEffects of diabetes on serum potassium concentrations in acute coronary syndromes . Heart2003;89:31-5.
36.
Weston PJ, Gill GVIs undetected autonomic dysfunction responsible for sudden death in type 1 diabetes mellitus? The `dead in bed' syndrome revisited. Diabet Med1999;16:626-31.
37.
Ranjadayalan K., Umachandran V., Ambepityia G., Kopelman PG, Mills PG, Timmis ADProlonged anginal perceptual threshold in diabetes: effects on exercise capacity and myocardial ischemia. J Am Coll Cardiol1990; 16:1120-4.
38.
Ambepityia G., Kopelman PG, Ingram D., Swash M., Mills PG, Timmis ADExertional myocardial ischemia in diabetes: a quantitative analysis of anginal perceptual threshold and the influence of autonomic funtion. J Am Coll Cardiol1990 ;15:72-7.