Influence of type 2 diabetes on symbolic analysis and complexity of heart rate variability in men

Sílvia C G Moura-Tonello, Anielle C M Takahashi, Cristina O. Francisco, Sérgio L B Lopes, Adriano M. Del Vale, Audrey Borghi-Silva, Angela M O Leal, Nicola Montano, Alberto Porta, Aparecida M. Catai

Research output: Contribution to journalArticlepeer-review


Background: Individuals with diabetes may develop cardiac autonomic dysfunction that may be evaluated by heart rate variability (HRV). The aim was evaluated heart rate variability (HRV) of individuals with type 2 diabetes, without cardiovascular autonomic neuropathy (CAN), in response to active postural maneuver by means of nonlinear analysis (symbolic analysis, Shannon and conditional entropy) and correlate HRV parameters between them, glycated hemoglobin and diabetes duration. Methods. Nineteen men with type 2 diabetes without CAN (T2D) and nineteen healthy men (CG), age-range from 40 to 60 years were studied. We assessed HRV in supine and orthostatic position using symbolic analysis (0V%, 1V%, 2LV% and 2UV%), Shannon and conditional entropy (SE and NCI). Results: In supine position T2D presented higher sympathetic modulation (0V%) than CG. However, there was not any difference between groups for indexes of complexity (SE and NCI). Furthermore, T2D presented a preserved response of cardiac autonomic modulation after active postural maneuver. Conclusions: The present study showed that individuals with type 2 diabetes without CAN presented higher cardiac sympathetic modulation. However, the complexity of HRV was not influenced by imbalance of the autonomic modulation in individuals with type 2 diabetes. In addition, the response of autonomic nervous system in the heart remains preserved after active postural maneuver in individuals with type 2 diabetes, possibly due to the lack of CAN in this group.

Original languageEnglish
Article number13
JournalDiabetology and Metabolic Syndrome
Issue number1
Publication statusPublished - Feb 1 2014


  • Heart rate variability
  • Shannon entropy and conditional entropy
  • Symbolic analysis
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine


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