Cardiovascular autonomic neuropathy contributes to left ventricular diastolic dysfunction in subjects with Type2 diabetes and impaired glucose tolerance undergoing coronary angiography

Aims Left ventricular diastolic dysfunction is considered a precursor of diabetic cardiomyopathy, while diabetic cardiovascular autonomic neuropathy is associated with an increased risk of mortality. This study aimed to evaluate the association between left ventricular diastolic dysfunction and cardiovascular autonomic neuropathy, both diagnosed according to the current guidelines. Methods We evaluated 145 patients referred for an elective coronary angiography, 52 of whom had Type2 diabetes and 48 had impaired glucose tolerance, while 45 subjects had normal glucose tolerance. Cardiovascular autonomic neuropathy was diagnosed using autonomic function tests, while left ventricular diastolic dysfunction was verified by tissue Doppler imaging echocardiography. Results Cardiovascular autonomic neuropathy was diagnosed in 15 (28.8%) patients with Type2 diabetes and in six (12.5%) individuals with impaired glucose tolerance. The rates of left ventricular diastolic dysfunction were 81 and 33% in patients with and without cardiovascular autonomic neuropathy, respectively (P