Cardiovascular autonomic neuropathy (CAN) is a common and deadly complication of diabetes mellitus, which is frequently overlooked in clinical practice due to its characteristic subtle presentation earlier in disease. Yet, timely detection of CAN may help implementation of tailored interventions to prevent its progression and mitigate the risk of associated complications, including cardiovascular disease (CVD), cardiac arrhythmias, myocardial dysfunction leading to congestive heart failure and all-cause mortality. This review highlights current CAN epidemiology trends, novel mechanisms linking CAN with other diabetes complications and current recommendations for diagnosis and management of the disease in the clinical setting.

中文翻译：

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心血管自主神经病变：影响深远的无声杀手


心血管自主神经病变（CAN）是糖尿病的一种常见且致命的并发症，由于其在疾病早期表现出微妙的特征，因此在临床实践中经常被忽视。然而，及时检测 CAN 可能有助于实施量身定制的干预措施，以防止其进展并降低相关并发症的风险，包括心血管疾病 (CVD)、心律失常、导致充血性心力衰竭和全因死亡的心肌功能障碍。这篇综述重点介绍了当前 CAN 的流行病学趋势、将 CAN 与其他糖尿病并发症联系起来的新机制以及当前临床环境中对该疾病的诊断和管理的建议。