Diabetes alters cardiorespiratory dynamics: insights from short-term recurrence quantification analysis of pulse-respiration quotient

Area of Science:

• Cardiorespiratory physiology
• Autonomic nervous system function
• Diabetes mellitus research

Background:

• Type 2 diabetes mellitus (T2DM) is known to disrupt autonomic control.
• Cardiorespiratory dynamics may be compromised in T2DM due to impaired autonomic regulation.
• Assessing cardiorespiratory interactions is crucial for understanding T2DM-related complications.

Purpose of the Study:

• To investigate alterations in cardiorespiratory dynamics in individuals with T2DM.
• To compare the effectiveness of linear indices and Recurrence Quantification Analysis (RQA) in detecting T2DM-related changes.
• To explore the impact of T2DM on cardiorespiratory coupling.

Main Methods:

• Cross-sectional study of 38 participants (20 T2DM, 18 controls).
• Continuous recording of electrocardiographic and respiratory signals during supine rest, orthostatic challenge, paced breathing, and Valsalva maneuver.
• Analysis of Pulse-Respiration Quotient (PRQ) time series using linear indices and RQA, alongside mutual information (MI) for cardiorespiratory coupling.

Main Results:

• T2DM participants showed higher recurrence rates and prolonged recurrence time in PRQ signals, indicating reduced adaptability.
• RQA metrics were more sensitive than linear indices in differentiating between T2DM and control groups.
• Mutual information analysis revealed distinct compensatory cardiorespiratory coupling patterns in T2DM during specific tasks.

Conclusions:

• T2DM is associated with altered cardiorespiratory dynamics and reduced adaptability.
• Findings suggest potential dysautonomia or autonomic dysregulation in individuals with T2DM.
• RQA offers a valuable tool for assessing subtle cardiorespiratory changes in T2DM.