A vectorcardiographic study of spatial P, QRS and T-loops in diabetic patients without clinically apparent heart disease

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Summary Eighty-nine ambulatory normotensive diabetic patients, free of cardiorespiratory symptoms at any time or any clinical or x-ray evidence of cardiac involvement except for electrocardiographic abnormalities (50.5%), have been studied vectorcardiographically. The abnormalities of the spatial QRS, T and P-loops have been analyzed with regard to the presence of bites, T-loop length/width (L/W) ratio and intra-atrial conduction disturbances. Forty-one percent of patients had QRS bites with a duration more than 10 msec and an amplitude more than 0.1 mV. Thirty-eight percent had an abnormal spatial T-loop L/W ratio of less than 2.6. Twenty-five percent had intra-atrial conduction disturbances. The vectorcardiograms (VCGs) showed 75% of diabetic patients presenting abnormalities of the QRS, T or P-loop (single or combined). These abnormalities may be caused by small and large coronary vessels and myocardial involvement, or they may be due to biochemical changes at the level of the cellular between the duration of the disease, diet or hypoglycemic medication and the vectorcardiographic abnormalities. We concluded that vectorcardiography is a reliable and important non-invasive method for detecting subclinical cardiac abnormalities in patients with diabetes mellitus.