Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Πέτρος Π. Σφηκάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γρηγόριος Καλτσάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Τεντολούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Σιάσος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μακρυλάκης Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Κόκκινος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Αθανάσιος Πρωτογέρου, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η συσχέτιση της υπογλυκαιμίας με ηλεκτροκαρδιογραφικές διαταραχές σε ασθενείς με σακχαρώδη διαβήτη
Translated title:
Severe iatrogenic hypoglycaemia requiring medical assistance is associated with concurrent prolongation of QTc interval
Summary:
Background and aims:
Hypoglycemia induces pre-arrhythmic changes, mainly by QT prolongation, possibly leading to sudden death. Herein, we explore the association between severe hypoglycemic events requiring medical assistance and the QTc interval in patients with diabetes.
Materials and methods:
Nine Greek clinics participated in a prospective survey of iatrogenic hypoglycemia at the emergency departments. According to our protocol, a 12-lead ECG was obtained simultaneously or immediately after the management of hypoglycemia. The patients’ ECGs were compared to a matched control group during the same time period. QT and RR intervals were measured blindly by two cardiologists. QTc was calculated according to the Bazett formula. Patients under medication affecting QTc and those with hypokalemia were excluded.
Results:
154 ECGs from hypoglycemic patients were analyzed and compared to 95 sex and age matched controls. The mean QTc interval in patients with hypoglycaemia was 441.9 (48.2) msec vs. 401.0 (29.6) msec in the control group, a difference of high statistical significance (p<0.001). A significantly higher proportion of hypoglycemic patients had an abnormally prolonged QTc (≥440msec) compared to controls (49.4% vs. 11.6%, p<0.001). Among patients with hypoglycaemia, there was a statistically significant negative correlation between QTc interval length and plasma glucose at presentation (r: -0.183, p=0.02). Qualitative assessment of the ECGs did not reveal any major tachyarrhythmic disorders in either patients or controls. There was one hypoglycaemic patient presenting with third degree atrioventricular block, as well 16 ECGs from hypoglycaemic patients with at least one ventricular premature beat versus only two in controls.
Conclusion:
In patients with diabetes, severe iatrogenic hypoglycemia requiring medical assistance is associated with a both statistically and clinically significant prolongation of the QTc interval.
Main subject category:
Health Sciences
Keywords:
Hypoglycemia, Diabetes mellitus, QT interval prolongation
Number of references:
195
File:
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ΜΥΛΩΝΑ ΜΑΡΙΑ_PhD _12. 2020 PERGAMOS.pdf
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File access is restricted only to the intranet of UoA.
