Tip 2 diabetes mellitus hastalarında hipergliseminin kardiyak repolarizasyon parametrelerine akut etkileri

Evrim Simsek

doi:10.19161/etd.698693

EN TR

Acute effects of hyperglisemia on cardiac repolarisation parameters in patients with type 2 diabetes mellitus

Abstract

Aim: Sudden cardiac death is more common in patients with type 2 diabetes mellitus (DM). Repolarization parameters on electrocardiography (ECG) including the QT and Tpe interval may be useful for determining the arrhythmic risk. Comparison of these parameters in patients with type 2 DM and healthy individuals has not been studied much. Also, the difference between hyper and normoglycemic periods has not been evaluated before.The aim of this study was to compare the QT and Tpe in type 2 DM patients with control group and to show the differences in the hyper and normoglycemic periods.

Materials and Methods: Thirty type 2 DM patients needed insulin infusion and 30 healthy individuals of similar age and sex were included in the study. ECGs performed before and after ınsulin infusion. QT, Tpe and heart rates were measured, and QT corrected for heart rate (QTc), Tpe corrected for heart rate (Tpec) and QTc (TpeQTc) values were calculated. Results of the hyper and normoglycemic status and control group were compared.

Results: The mean age of the patients was 54.2 years and 53.3% of them were female. Heart rate was higher and Tpec and QTc periods were statistically longer in the both hyper and normoglycemic period compared to the control group. QTc, Tpe, Tpec, TpeQTc parameters were longer in hyperglycemic period than normoglycemic period (QTc:45331 to 43433 p=0.003, Tpe:95.211.9 to 82.311.8 p<0.001, Tpec:112.518.1 to 96.416.1 p <0.001, TpeQTc:0.2100.023 to 0.1900.02 p<0.001).

Conclusion: QTc and Tpec parameters were longer in patients with type 2 DM than in healthy subjects, whereas these parameters were longer in hyperglycemic period than in normoglycemic period. Therefore, arrhythmic risks of DM patients may be even higher in the hyperglycemic period.

Keywords

Tip 2 diabetes mellitus hastalarında hipergliseminin kardiyak repolarizasyon parametrelerine akut etkileri

Öz

Amaç: Ani kardiyak ölüm tip 2 Diabetes Mellitus (DM) hastalarında daha sık görülmektedir. Aritmi riskinin belirlenmesi için elektrokardiografide (EKG) repolarizasyonu gösteren QT intervali ve T dalgasının tepesinden sonuna kadar olan süreyi tanımlayan “T wave peak to end time” (Tpe) intervali yararlı olabilmektedir. Bu parametrelerin tip 2 DM hastalarında genel popülasyona göre değişimi fazla çalışılmamıştır. Hastaların hipergilisemik ve normoglisemik dönemlerinde bu parametreleri içeren karşılaştırma ise daha önce yapılmamıştır. Çalışmanın amacı tip 2 DM hastalarında aritmik riskin göstergesi olabilecek QT ve Tpe parametrelerin sağlıklı kontrol grubuyla karşılaştırılması ve hastaların hiperglisemik ve normoglisemik dönemlerinde bu parametrelerdeki değişimin gösterilmesidir.

Gereç ve Yöntem: İnsülin infüzyonu başlanan 30 tip 2 DM hastası ile benzer yaş ve cinsiyette 30 sağlıklı birey çalışmaya alınmıştır. DM hastaların insülin infüzyonu öncesi ve sonrası EKG‟leri çekilmiş, QT, Tpe ve kalp hızları ölçülüp kalp hızına göre düzeltilmiş QT (QTc), sırasıyla kalp hızı ve QTc ye göre düzeltilmiş, Tpec ve TpeQTc değerleri hesaplanıp hem kendi aralarında hem de sağlıklı kontrol grubunun ölçümleri ile karşılaştırılmıştır.

Bulgular: Hastaların ortalama yaşı 54,2 yıl ve %53,3‟ü kadındı. Hasta grubunda hiperglisemik ve normoglisemik dönemde kontrol grubuna göre kalp hızı daha yüksek, Tpec ve QTc süreleri istatistiksel olarak daha uzundu. Hiperglisemik dönem ile normoglisemik dönem kendi aralarında karşılaştırldığında QTc, Tpe, Tpec, TpeQTc parametrelerinin hepsi hiperglisemik dönemde daha uzun bulundu. (Sırasıyla QTc:45331‟e karşı 43433 p=0,003, Tpe:95,211,9‟a karşı 82,311,8 p<0,001, Tpec:112,518,1‟e karşı 96,416,1 p<0,001, TpeQTc:0,2100,023‟e karşı 0,1900,02 p<0,001)

Sonuç: Tip 2 DM hastalarında QTc, Tpec parametreleri sağlıklı kişilere göre uzunken hiperglisemik dönemde bu parametreler normoglisemik döneme göre daha da uzundur. Bu nedenle DM hastaların aritmik riskleri hiperglisemik dönemde daha da yüksek olabilir.

Anahtar Kelimeler

References

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Evrim Simsek ^*
0000-0003-3183-8060
Türkiye

Publication Date

March 13, 2020

Submission Date

October 15, 2019

Acceptance Date

November 11, 2019

Published in Issue

Year 2020 Volume: 59 Number: 1

DOI

https://doi.org/10.19161/etd.698693

IZ

https://izlik.org/JA55ZK95KS

Cite

RIS / Bibtex

Vancouver

1.Evrim Simsek. Tip 2 diabetes mellitus hastalarında hipergliseminin kardiyak repolarizasyon parametrelerine akut etkileri. EJM. 2020 Mar. 1;59(1):47-54. doi:10.19161/etd.698693

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