The relationship between right ventricular deformation and heart rate variability in asymptomatic diabetic patients

Marijana Tadic, Vladan Vukomanovic, Cesare Cuspidi, Jelena Suzic-Lazic, Biljana Pencic-Popovic, Jana Radojkovic, Rade Babic, Vera Celic

Research output: Contribution to journalArticlepeer-review


Objective To investigate heart rate variability (HRV) and right ventricular (RV) remodeling in asymptomatic diabetic patients, as well as the relationship between HRV indices and RV structure, function and deformation. Method This cross-sectional study included 59 asymptomatic patients with type 2 diabetes and 45 healthy controls without cardiovascular risk factors. All study subjects underwent 24-h Holter monitoring, laboratory analyses and complete two-dimensional echocardiography examination (2DE). Results RV diastolic function and longitudinal deformation were significantly impaired in diabetic individuals comparing with controls. RV global longitudinal strain and layer-specific longitudinal strains were significantly decreased in diabetic group. The same trend of changes in RV deformation was observed for global RV and lateral wall. All parameters of time and frequency domain of HRV were reduced in diabetic subjects. RV endocardial longitudinal strain together with LV mass index, mitral E/e’ ratio and HbA1c correlated with HRV parameters. However, multivariate linear regression analysis showed that only RV endocardial longitudinal strain and LV mass index are associated with HRV parameters independently of age, BMI, HbA1c, RV free wall thickness and pulmonary artery pressure. Conclusions RV subendocardial strain is independently associated with HRV parameters in the whole study population. This reveals potentially important role of determination of layer-specific RV longitudinal function as important marker of preclinical cardiac damage, but also indirectly show the impairment of cardiac autonomic function in diabetic patients.

Original languageEnglish
Pages (from-to)1152-1157
Number of pages6
JournalJournal of Diabetes and its Complications
Issue number7
Publication statusPublished - Jul 1 2017


  • Diabetes
  • Heart rate variability
  • Multilayer strain
  • Right ventricle
  • Strain

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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