Sardu C, et al. - In this prospective multicenter study, researchers examined the association between heart rate variability (HRV) alterations and vasovagal syncope (VVS) recurrence at 12 months of follow up in patients with type 2 diabetes mellitus (T2DM) vs non T2DM patients. For this investigation, they studied a propensity score matching (PSM) analysis of 121 T2DM vs 121 non-T2DM patients affected by VVS. Findings suggested an association of blood pressure alterations and lower LF/HF ratio with a higher rate of all-cause syncope recurrence and of vasodepressor, cardioinhibitory, and mixed syncope recurrence. Due to cardiac autonomic neuropathy, T2DM patients have changes in the autonomic nervous system. However, VVS predicted recurrence in the diagnosis of T2DM and autonomic dysfunction evaluated by HRV alterations.