Abstract
Background. Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes mellitus. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as high as 90% of diabetic patients. Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function. This study was conducted to assess the relationship between Cardiac autonomic neuropathy and QT interval. Material and methods. This was a cross-sectional study conducted in 100 patients attending a tertiary care hospital in India. Deep breathing test, Valsalva ratio, immediate heart rate response to standing 30 : 15, BP rise with sustained hand grip and postural hypotension were evaluated. Scoring was done for cardiac autonomic neuropathy. QT interval and QTc interval were determined and association with CAN was obtained. Results. Out of 100 type 2 diabetic patients, 60% were males and 40% were females. 25 patients having no cardiac autonomic neuropathy and had no prolonged QTc interval. While, 75 patients had QTc prolonged were associated with early and severe CAN cardiac autonomic neuropathy. The prolonged QTc was significantly associated with CAN in diabetic patients when compared without CAN and controls (P < 0.0001). The grading score for CAD showed that 75% cases were having score > 2 were 25% of cases had score < 2. Out of 75 patients 44 were between score 2–4 and 31 were above score 4. A significant association between QTc and Diabetic CAN patients observed when compared non CAN and controls. Conclusions. Diabetic cardiac autonomic neuropathy is associated with increase in prolongation of QTc intervals. Hence, there is need for regular checkup of autonomic nervous system in diabetic patient to prevent further complications.
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