Research Article
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Tip 2 diyabetes mellitus hastalarında elektrokardiyografik aritmojenite indekslerinin değerlendirilmesi

Year 2023, Volume: 4 Issue: 5, 431 - 435, 27.10.2023
https://doi.org/10.47582/jompac.1349901

Abstract

Amaçlar: Diyabetes mellitus (DM) hiperglisemi ve proinflamatuvar süreçle ilerleyen kronik bir hastalıktır. DM’ye bağlı en sık görülen komplikasyon kardiyovasküler hastalıklardır. DM hastalarında aritmi riskinin de arttığı bilinmektedir. Çalışmamızın amacı DM tanılı hastalarda elektrokardiyografik aritmojenite indekslerinin kan glukoz regülasyonu ile ilişkisini değerlendirmektir.
Yöntemler: Çalışmaya 77 tip 2 DM tanlı hasta ve kontrol grubu olarak 76 sağlıklı birey alındı. Hastaların boy, kilo, beden kitle indeksleri, HbA1c ve açlık kan glukoz düzeyleri kayıt altına alındı. Hastaların 12 derivasyon EKG’leri çekilerek düzeltilmiş QT (QTc), T peak-T end (Tp-e) ve Tp-e/QTc değerleri hesaplandı. Sonuçlar istatistiksel olarak değerlendirildi.
Bulgular: Tp-e intervali (p<0.001), the QTc intervali (p<0.05) ve Tp-e/QTc oranı (p<0.001) DM hasta grubunda kontrol grubuna göre anlamlı olarak uzamış olduğu görüldü.
Sonuç: Ucuz ve güvenilir bir tanı yöntemi olması nedeniyle EKG, DM hastalarının kardiyak koplikasyonlarının değerlendirilmesinde kullanılmalıdır. Çalışmamızın sonucu olarak QTc, Tp-e intervali ve Tp-e/QTc oranı DM hastalarında aritmi riskini öngörmede kullanılabilecek markerlardır.

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References

  • Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365(9467):1333-1346.
  • Rivellese AA, Riccardi G, Vaccaro O. Cardiovascular risk in women with diabetes. Nutr Metab Cardiovasc Dis. 2010;20(6):474-480.
  • Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956-962.
  • Verrier RL, Antzelevitch C. Autonomic aspects of arrhythmogenesis: the enduring and the new. Curr Opin Cardiol. 2004;19(1):2-11.
  • Kluppelholz B, Thorand B, Koenig W, et al. Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study. Diabetologia. 2015;58(10):2269-2277.
  • Aburisheh K, AlKheraiji MF, Alwalan SI, et al. Prevalence of QT prolongation and its risk factors in patients with type 2 diabetes. BMC Endocr Disord. 2023;23(1):50.
  • Cox AJ, Azeem A, Yeboah J, et al. Heart rate-corrected QT interval is an independent predictor of all-cause and cardiovascular mortality in individuals with type 2 diabetes: the Diabetes Heart Study. Diabetes Care. 2014;37(5):1454-1461.
  • Naas AA, Davidson NC, Thompson C, et al. QT and QTc dispersion are accurate predictors of cardiac death in newly diagnosed non-insulin dependent diabetes: cohort study. BMJ. 1998;316(7133):745-746.
  • Tokatli A, Kiliçaslan F, Alis M, Yiginer O, Uzun M. Prolonged Tp-e Interval, Tp-e/QT Ratio and Tp-e/QTc Ratio in Patients with Type 2 Diabetes Mellitus. Endocrinol Metab (Seoul). 2016;31(1):105-112.
  • Kuzu F. The effect of type 2 diabetes on electrocardiographic markers of significant cardiac events. Pak J Med Sci. 2018;34(3):626-632.
  • Yamaguchi M, Shimizu M, Ino H, et al. T wave peak-to-end interval and QT dispersion in acquired long QT syndrome: a new index for arrhythmogenicity. Clin Sci. 2003;105(6):671-676.
  • Dahlberg P, Diamant UB, Gilljam T, Rydberg A, Bergfeldt L. QT correction using Bazett’s formula remains preferable in long QT syndrome type 1 and 2. Ann Noninvasive Electrocardiol. 2021;26(1):e12804.
  • Svane J, Pedersen-Bjergaard U, Tfelt-Hansen J. Diabetes and the Risk of Sudden Cardiac Death. Curr Cardiol Rep. 2020;22(10):112.
  • Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744.
  • Stern K, Cho YH, Benitez-Aguirre P, et al. QT interval, corrected for heart rate, is associated with HbA1c concentration and autonomic function in diabetes. Diabet Med. 2016;33(10):1415-1421.
  • Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744. doi:10.1007/s00592-016-0864-y
  • Agarwal G, Singh SK. Arrhythmias in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2017;21(5):715-718.
  • Castro-Torres Y, Carmona-Puerta R, Katholi RE. Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice. World J Clin Cases. 2015;16:3(8):705-720.
  • Ardahanlı İ, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res. 2020; 27(12):3117-3122.
  • Fox CS, Sullivan L, D’Agostino RB Sr, Wilson PW; Framingham Heart Study. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004;27(3):704-708.
  • Kishi S, Gidding SS, Reis JP, et al. Association of insulin resistance and glycemic metabolic abnormalities with LV structure and function in middle age: the CARDIA Study. JACC Cardiovasc Imaging. 2017;10(2):105-114.
  • Haffner SM, Mitchell BD, Stern MP, Hazuda HP. Macrovascular complications in Mexican Americans with type II diabetes. Diabetes Care. 1991;14(7):665-671.
  • Waheed S, Dawn B, Gupta K. Association of corrected QT interval with body mass index, and the impact of this association on mortality: results from the third national health and nutrition examination survey. Obes Res Clin Pract. 2017;11(4):426-434.
  • Bağcı A, Aksoy F. The frontal plane QRS-T angle may affect our perspective on prehypertension: a prospective study. Clin Exp Hypertens. 2021;43(5):402-407.
  • Csige I, Ujvárosy D, Szabó Z, et al. The impact of obesity on the cardiovascular system. J Diabetes Res. 2018;2018:3407306.
  • Lambert EA, Straznicky NE, Dixon JB, Lambert GW. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? Am J Physiol Heart Circulatory Physiol. 2015;309(2):H244-H58.

Evaluation of electrocardiographic arrhythmogenicity markers in patients with type 2 diabetes mellitus

Year 2023, Volume: 4 Issue: 5, 431 - 435, 27.10.2023
https://doi.org/10.47582/jompac.1349901

Abstract

Aims: Diabetes mellitus (DM) is a chronic disease that progresses with hyperglycemia and the proinflammatory process. The most common complication of DM is cardiovascular disease, and it is known that the risk of arrhythmia increases in patients with DM. The aim of our study was to evaluate the correlation of electrocardiographic arrhythmogenicity markers with HbA1c and fasting blood glucose.
Methods: The study included 77 type 2 DM patients and 76 healthy individuals as a control group. Body mass index, HbA1c value, and fasting blood glucose level were recorded for all patients. Corrected QT (QTc), T peak-T end intervals (Tp-e), and Tp-e/QTc values were calculated from 12-lead electrocardiography (ECG). The results were evaluated statistically.
Results: The Tp-e interval (p<0.001), QTc interval (p<0.05), and Tp-e/QTc ratio (p<0.001) were significantly prolonged within the DM group compared to the control group.
Conclusion: ECG, an inexpensive and reliable diagnostic method, can be used to evaluate the risk of arrhythmia in DM patients. This study concluded that QTc, Tp-e interval, and Tp-e/QTc ratio are markers that can be used to predict arrhythmia risk in DM patients.

References

  • Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365(9467):1333-1346.
  • Rivellese AA, Riccardi G, Vaccaro O. Cardiovascular risk in women with diabetes. Nutr Metab Cardiovasc Dis. 2010;20(6):474-480.
  • Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956-962.
  • Verrier RL, Antzelevitch C. Autonomic aspects of arrhythmogenesis: the enduring and the new. Curr Opin Cardiol. 2004;19(1):2-11.
  • Kluppelholz B, Thorand B, Koenig W, et al. Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study. Diabetologia. 2015;58(10):2269-2277.
  • Aburisheh K, AlKheraiji MF, Alwalan SI, et al. Prevalence of QT prolongation and its risk factors in patients with type 2 diabetes. BMC Endocr Disord. 2023;23(1):50.
  • Cox AJ, Azeem A, Yeboah J, et al. Heart rate-corrected QT interval is an independent predictor of all-cause and cardiovascular mortality in individuals with type 2 diabetes: the Diabetes Heart Study. Diabetes Care. 2014;37(5):1454-1461.
  • Naas AA, Davidson NC, Thompson C, et al. QT and QTc dispersion are accurate predictors of cardiac death in newly diagnosed non-insulin dependent diabetes: cohort study. BMJ. 1998;316(7133):745-746.
  • Tokatli A, Kiliçaslan F, Alis M, Yiginer O, Uzun M. Prolonged Tp-e Interval, Tp-e/QT Ratio and Tp-e/QTc Ratio in Patients with Type 2 Diabetes Mellitus. Endocrinol Metab (Seoul). 2016;31(1):105-112.
  • Kuzu F. The effect of type 2 diabetes on electrocardiographic markers of significant cardiac events. Pak J Med Sci. 2018;34(3):626-632.
  • Yamaguchi M, Shimizu M, Ino H, et al. T wave peak-to-end interval and QT dispersion in acquired long QT syndrome: a new index for arrhythmogenicity. Clin Sci. 2003;105(6):671-676.
  • Dahlberg P, Diamant UB, Gilljam T, Rydberg A, Bergfeldt L. QT correction using Bazett’s formula remains preferable in long QT syndrome type 1 and 2. Ann Noninvasive Electrocardiol. 2021;26(1):e12804.
  • Svane J, Pedersen-Bjergaard U, Tfelt-Hansen J. Diabetes and the Risk of Sudden Cardiac Death. Curr Cardiol Rep. 2020;22(10):112.
  • Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744.
  • Stern K, Cho YH, Benitez-Aguirre P, et al. QT interval, corrected for heart rate, is associated with HbA1c concentration and autonomic function in diabetes. Diabet Med. 2016;33(10):1415-1421.
  • Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744. doi:10.1007/s00592-016-0864-y
  • Agarwal G, Singh SK. Arrhythmias in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2017;21(5):715-718.
  • Castro-Torres Y, Carmona-Puerta R, Katholi RE. Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice. World J Clin Cases. 2015;16:3(8):705-720.
  • Ardahanlı İ, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res. 2020; 27(12):3117-3122.
  • Fox CS, Sullivan L, D’Agostino RB Sr, Wilson PW; Framingham Heart Study. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004;27(3):704-708.
  • Kishi S, Gidding SS, Reis JP, et al. Association of insulin resistance and glycemic metabolic abnormalities with LV structure and function in middle age: the CARDIA Study. JACC Cardiovasc Imaging. 2017;10(2):105-114.
  • Haffner SM, Mitchell BD, Stern MP, Hazuda HP. Macrovascular complications in Mexican Americans with type II diabetes. Diabetes Care. 1991;14(7):665-671.
  • Waheed S, Dawn B, Gupta K. Association of corrected QT interval with body mass index, and the impact of this association on mortality: results from the third national health and nutrition examination survey. Obes Res Clin Pract. 2017;11(4):426-434.
  • Bağcı A, Aksoy F. The frontal plane QRS-T angle may affect our perspective on prehypertension: a prospective study. Clin Exp Hypertens. 2021;43(5):402-407.
  • Csige I, Ujvárosy D, Szabó Z, et al. The impact of obesity on the cardiovascular system. J Diabetes Res. 2018;2018:3407306.
  • Lambert EA, Straznicky NE, Dixon JB, Lambert GW. Should the sympathetic nervous system be a target to improve cardiometabolic risk in obesity? Am J Physiol Heart Circulatory Physiol. 2015;309(2):H244-H58.

Details

Primary Language English
Subjects Cardiology, Endocrinology
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Cem Onur KIRAÇ 0000-0002-0249-9867

Project Number yok
Early Pub Date October 26, 2023
Publication Date October 27, 2023
Published in Issue Year 2023 Volume: 4 Issue: 5

Cite

AMA KIRAÇ CO. Evaluation of electrocardiographic arrhythmogenicity markers in patients with type 2 diabetes mellitus. J Med Palliat Care / JOMPAC / jompac. October 2023;4(5):431-435. doi:10.47582/jompac.1349901

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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