The evaluation of QTc prolongation and QT dispersion in type 2 diabetes mellitus as an indicator of cardiac autonomic neuropathy

Authors

  • Devinder Singh Mahajan Department of Medicine, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Hardeep Singh Deep Department of Medicine, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Navdeep Singh Department of Medicine, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Sukhjit Kaur Department of Pediatrics, Government Medical College, Amritsar, Punjab, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20195637

Keywords:

Cardiac autonomic neuropathy, Diabetes mellitus, QTc interval

Abstract

Background: Diabetes mellitus refers to group of metabolic disorders characterized by hyperglycemia due to an absolute or relative deficit in insulin production or action. Diabetes mellitus produces pathological changes in most organs of the body including heart, blood vessels, kidneys, nerves and eyes. Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed complication of diabetes. Diabetes-associated cardiovascular autonomic neuropathy damages autonomic nerve fibers that innervate the heart and blood vessels causing abnormalities in heart rate and vascular dynamics.

Methods: Total 80 cases of diabetes mellitus were selected. Cardiac autonomic neuropathy in them was diagnosed by a series of tests recommended by Ewing et al, which include - Valsalva ratio, Deep Breath Test, Heart rate response to standing, Postural Hypotension, SHGT Increase in diastolic BP on sustained hand grip. They were divided into 2 groups A and B depending on presence or absence of cardiac autonomic neuropathy. ECG was done to calculate QTc and QTd.

Results: In group A mean QTc was 0.344 sec and in group B in patients with mild CAN mean QTc was 0.432, moderate CAN mean QTc was 0.444, and in patients of severe CAN mean QTc was 0.481. p value was 0.001 that it is highly significant. Means more was degree of CAN more was prolongation of QT and similarly more the degree of CAN more was QTd.

Conclusions: Diagnosis of cardiac autonomic neuropathy by battery of cardiac autonomic function tests is a comlex procedure. The prolongation of QTc interval and more specifically QTd interval on ECG is a marker in diagnosis of cardiac autonomic neuropathy which can be easily evaluated.

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Published

2019-12-23

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Original Research Articles