Abstract
Background & Objectives:In diabetics, cardiac microvascular circulation disorder increases the risk of arrhythmia and sudden cardiac death. Tpeak-Tend (Tp-e) interval, Tp-e dispersion, and Tp-e/QT and Tp-e/QTc ratios measured by surface electrocardiogram (ECG) are new parameters used to evaluate ventricular arrhythmogenity. We aimed to compare QT dispersion (QTd), corrected QT dispersion (QTcd), P dispersion (Pd), Tp-e interval, Tp-e dispersion, and Tp-e/QT and Tp-e/QTc ratios in patients with type- 2 diabetes (T2D) with healthy population.Methods:Electrocardiographic parameters of a total of 100 patients diagnosed with T2D were retrospectively analyzed and compared with the ECG results of 100 healthy age-, sex-, and body weight and height-matched controls.Results:The Pd, QT interval, QTc interval, QTd, QTcd, Tp-e/QT, Tp-e/QT ratios were higher in the patients. A statistically significant correlation was found only between hemoglobin A1c and Tp-e dispersion, QTd, QTcd, Pd, Tp-e/QT and Tp-e/QTc parameters, in linear regression analysis. There was also a statistically significant positive correlation between the values of low-density lipoprotein, systolic blood pressure, and Tp-e dispersion.Conclusion:The risk of arrhythmia can be predicted by evaluating Tp-e interval, Tp-e dispersion, Tp-e/QT, and Tp-e/QTc ratio, suggesting heterogeneity of ventricular repolarization and P wave and Pd showing heterogeneity of atrial repolarization in diabetic patients.
Highlights
Patients with diabetes mellitus have a high risk of cardiovascular disease and the cardiovascular complications are the leading cause of morbidity1
QT dispersion (QTd) was calculated as the difference between the longest and shortest QT intervals (QTd=QTmax - QTmin), while QTc dispersion (QTcd) was calculated as the difference between the longest QTc and the shortest QTc (QTcd=QTc max-QTc min)
Agea Male/Female (n) Heighta Weighta Systolic blood pressurea Diastolic blood pressurea Triglycerideb Cholesterola LDLa HDLa Fasting glucoseb HbA1c (%)b TSHa Free T4a Hemoglobina Hematocrit (%)a Sodiuma Potassiuma Calciuma Smoker/non-smoker (n) aVariables are expressed in mean ± standard deviation, bVariables are expressed in median
Summary
Correspondence: January 9, 2018 May 7, 2018 and mortality associated with diabetes.[1] Type-2 diabetes (T2D) creates a prothrombotic state, leading to acute coronary syndromes by both endothelial damage and reducing antiaggregant factors, such as nitric oxide and prostacyclin and increasing thrombotic substances such as fibrinogen, factor VII, and suppressing fibrinolysis by factors such as plasminogen activator inhibitors.[2] Another important physiopathological process in diabetic patients is the glycosylation of low-density lipoprotein (LDL) particles. We aimed to compare QT dispersion (QTd), corrected QT dispersion (QTcd), P dispersion (Pd), Tp-e interval, Tp-e dispersion, and Tp-e/QT and Tp-e/QTc ratios in patients with type-2 diabetes (T2D) with healthy population. Conclusion: The risk of arrhythmia can be predicted by evaluating Tp-e interval, Tp-e dispersion, Tp-e/ QT, and Tp-e/QTc ratio, suggesting heterogeneity of ventricular repolarization and P wave and Pd showing heterogeneity of atrial repolarization in diabetic patients
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