Cardiac autonomic neuropathy epidemiology, pathogenesis and treatment

Domas Grigoravičius1, Laura Šiaulienė2

1 Faculty of Medicine, Vilnius University, Vilnius, Lituania.

2 Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.


Introduction: cardiac autonomic neuropathy is a common and severe complication of diabetes that involves parasympathetic and, as the disease progresses, sympathetic heart nervous fibers. Aim: this article aims to review the information available in the literature on the epidemiology, pathogenesis, and treatment of autonomic cardiac neuropathy. Literature search strategy: a literature search was performed using Google Scholar, PubMed, and Cochrane Library databases. The following terms were used together or individually, in different combinations: “cardiac”, “autonomic”, “neuropathy”, “dysfunction”, “assessment”, “diabetes”, “treatment”, “prediabetes”, “pathophysiology”, “pathology ”,“ epidemiology ”. Conclusion: the lesion is associated with a long duration of diabetic disease, but primary nerve lesion can also be observed in prediabetes. Treatment of autonomic cardiac neuropathy is based on symptom and pathogenetic factors control. There is still a lack of solid evidence for the effectiveness of pharmacological therapy, so reasonable control of cardiovascular risk factors and diabetes is the leading way to stop the progression of the disease. Cardiac autonomic neuropathy is associated with overall mortality and increased morbidity of cardiovascular system diseases.

Keywords: cardiac autonomic neuropathy, cardiac autonomic neuroapthy treatment, cardiac autonomic neuropathy etiology and pathogenesis.