Heart rate variability: short-term studies are as useful as holter to differentiate diabetic patients from healthy subjects

Abstract

BACKGROUND: The definitive incorporation of heart rate variability (HRV) as a clinical tool depends on the development of more confident techniques of measurement. The length of the studies is a critical issue. Whereas Holter studies allow the monitorization at different hours and activities, short-term recordings allow the control of environmental conditions. Recording length is also strongly related to the procedure of analysis; for instance, some time-domain indexes are strongly affected by the duration of the study. Meanwhile, spectral analyses require stationary conditions, only achieved in short-term studies. Our main goal was to determine if HRV indexes obtained from short-term analyses were as useful as those from Holter monitoring for diagnosis of reduced HRV in diabetes. METHODS: We studied two groups: one with impaired HRV (15 diabetic patients) and another with normal HRV (15 healthy subjects). HRV indexes obtained from 24-hour Holter recordings (SDNN, rMSSD, and the power of LF and HF bands), were correlated with analog indexes obtained from 10-minute digital acquired studies within each group. Besides, we compared the diabetic and control groups using the indexes obtained with both methodologies. RESULTS: The correlation was high (0.70<or=r <or= 0.85, P <or= 0.0032) in the diabetic group, but was poor in the control group. HRV values were significantly lower in the diabetic group either for 24-hour or short-term studies (P <or=0.0113). CONCLUSION: We conclude that short-term studies are at least as powerful as Holter to differentiate the diabetic group (impaired HRV) from the control group.