Evaluation of Index of Cardiac Electrophysiological Balance in Type 1 Diabetes Mellitus

Abstract

Background: Type 1 diabetes mellitus (T1DM) has been suggested to carry the risk of developing cardiac arrhythmias. The risk of cardiovascular events and sudden death is higher in patients with T1DM. The index of cardiac electrophysiological balance (iCEB), which shows the balance between ventricular depolarization and repolarization, is a new electrocardiographic (ECG) parameter when compared to other ECG parameters. iCEB provides more information on ventricular arrhythmo-genesis than the other traditional ECG parameters such as QT and corrected QT (QTc) intervals. The aim of this study is to evaluate the relationship between T1DM and iCEB.
Materials and Methods: This study was conducted retrospectively. The patient group consisted of 50 patients (58% male, mean age 32.9 ± 8.7 years) diagnosed with T1DM, while the control group consisted of 50 healthy individuals (58% male, mean age 33.9 ± 6.8 years). The clinical, demo-graphic and ECG records of the patients were obtained from our hospital's medical documentation system. iCEB and corrected iCEB (iCEBc) values of all participants were calculated by dividing the relevant QT and QTc intervals by the QRS duration.
Results: Mean PR, QRS, and QT intervals were similar between groups, while mean heart rate and QTc interval were found to be higher in the T1DM group than in healthy subjects [(83.1 ± 9.8 vs 78.9 ± 13.3 bpm, respectively, p = 0.019) and (425 ± 20.4 vs 397.6 ± 10.6 ms, respectively, p < 0.001)]. The iCEBc of the patient group with T1DM was higher than the control group (5.1 ± 0.5 vs 4.7 ± 0.4 ms, p <0.001, respectively). However, there was no significant difference in iCEB be-tween the patient and control groups (4.3 ± 0.4 and 4.3 ± 0.4 ms, respectively, p = 0.402).
Conclusions: In our study, iCEBc was found to be significantly increased in T1DM patients com-pared to healthy subjects. Consequently; it is important to evaluate the risk of ventricular ar-rhythmia with iCEBc in T1DM patients.

Key Words: Electrocardiography, Index of cardiac electrophysiological balance, Type 1 diabetes mellitus, Ventricular arrhythmia

Keywords

• Electrocardiography
• Index of cardiac electrophysiological balance
• Type 1 diabetes mellitus
• Ventricular arrhythmia
• Electrocardiography, Index of cardiac electrophysiological balance, Type 1 diabetes mellitus, Ventricular arrhythmia

Tip 1 Diabetes Mellitusta Kardiyak Elektrofizyolojik Denge İndeksinin Değerlendirilmesi

Abstract

Amaç: Tip 1 diabetes mellitus' un (T1DM) kardiyak aritmi geliştirme riski taşıdığı öne sürülmüştür. T1DM'li hastalarda kardiyovasküler olay ve ani ölüm riski daha yüksektir. Ventriküler depolarizasyon ve repolarizasyon arasındaki dengeyi gösteren kardiyak elektrofizyolojik denge indeksi (iCEB), diğer EKG parametreleri ile karşılaştırıldığında yeni bir elektrokardiyografik (EKG) parametredir. iCEB, QT ve düzeltilmiş QT (QTc) aralıkları gibi diğer geleneksel EKG parametrelerine göre ventriküler arit-mogenez hakkında daha fazla bilgi sağlar. Bu çalışmanın amacı, T1DM ve iCEB arasındaki ilişkiyi değerlendirmektir.
Materyal ve Metod: Bu retrospektif çalışma, T1DM tanısı almış toplam 50 hasta ile (% 58 erkek, ortalama yaş 32.9 ± 8.7 yıl) kontrol gurubunu oluşturmak üzere 50 sağlıklı denekten (% 58 erkek, ortalama yaş 33.9 ± 6.8 yıl) oluşmaktadır. Katılımcıların demografik, klinik ve EKG özellikleri has-tanemizin tıbbi tıbbi dökümentasyon sisteminden elde edildi. iCEB ve düzeltilmiş iCEB (iCEBc) değerleri, ilgili QT ve QTc aralıklarının QRS süresine bölünmesiyle hesaplandı.
Bulgular: Ortalama PR, QRS ve QT aralıkları gruplar arasında benzer iken, ortalama kalp hızı ve QTc intervali T1DM grubunda sağlıklı bireylere göre daha yüksekti [(sırasıyla 83.1 ± 9.8’ e karşı 78.9 ± 13.3 atım/dakika , p = 0.019) ve (425 ± 20.4’ e karşı 397.6 ± 10.6 ms, p <0.001)]. T1DM grubu kontrollere göre daha yüksek iCEBc' ye sahipti (sırasıyla 5.13 ± 0.5 'e karşı 4.71 ± 0.4 ms, p <0.001). Bununla birlikte, gruplar arasında iCEB açısından anlamlı bir saptanmadı (sırasıyla 4.38 ± 0.45 ve 4.33 ± 0.41 ms, p = 0,402).
Sonuç: Çalışmamızda iCEBc’ nin, T1DM hastalarında sağlıklı kişilere kıyasla önemli ölçüde artmış olduğu bulundu. Bu nedenle; T1DM hastalarında ventriküler aritmi riskinin iCEBc ile değerlendi-rilmesi önem taşımaktadır.

Anahtar kelimeler:

Keywords

• Elektrokardiyografi
• Kardiyak elektrofizyolojik denge indeksi
• Tip 1 diyabetes mellitus
• Ventriküler aritmi

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