Heart rate variability tests for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus in advanced stages of kidney disease
Authors' conclusion
Our findings suggest that it is possible to achieve high sensitivity and accuracy using an algorithm with VLF and TP parameters analyzed in series.
Study context
- Population
- Patients with T2D and diabetic kidney disease (DKD) with severely increased albuminuria
- Participants
- 48 patients
- Comparison
- Heart Rate Variability (HRV) tests vs cardiovascular autonomic reflex tests (CARTs) for diagnosing Cardiovascular Autonomic Neuropathy (CAN)
- Outcome
- Sensitivity and specificity of HRV tests to diagnose CAN
Methodological detailscross-sectional
- Cross-sectional
Performance
As reported in the abstract
Diagnostic performance of HRV tests for CAN
| Test or model | Cut-off | Sensitivity | F1 Score | Specificity | Accuracy |
|---|---|---|---|---|---|
| VLF | < 1,117 ms2 | 97% | 90% | ||
| LF | < 152.5 ms2 | 75% | |||
| TP | < 1,891 ms2 | 92% | 90% | 85% | |
| SDNN | < 46.5 ms |
Cut-off
VLF< 1,117 ms2
LF< 152.5 ms2
TP< 1,891 ms2
SDNN< 46.5 ms
Sensitivity
VLF97%
LF— not stated in the abstract
TP92%
SDNN— not stated in the abstract
F1 Score
VLF90%
LF— not stated in the abstract
TP90%
SDNN— not stated in the abstract
Specificity
VLF— not stated in the abstract
LF75%
TP— not stated in the abstract
SDNN— not stated in the abstract
Accuracy
VLF— not stated in the abstract
LF— not stated in the abstract
TP85%
SDNN— not stated in the abstract
- Serial algorithm (VLF first, then TP): sensitivity
- 97%
- Serial algorithm (VLF first, then TP): accuracy
- 90%
- Serial algorithm: reduction in need to perform CARTs
- 90%
Further findings
Prevalence of CAN by CARTs
- CAN confirmed
- 75% (36/48)
HRV values with vs without CAN
- VLF: 212 vs 522 ms2
- P = 0.024
- LF: 57 vs 332 ms2
- P = 0.025
- TP: 359.5 vs 2733 ms2
- P = 0.007
- SDNN: 20 vs 48 ms
- P = 0.012
- With CAN vs without CAN, respectively
Original publication
Heart rate variability tests for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus in advanced stages of kidney disease. Cardiovasc Diabetol. Published 28 March 2025. doi:10.
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