Περίληψη:
P>Aims
To examine differences in the spatial QRS-T angle in patients with Type
2 diabetes mellitus with and without cardiac autonomic neuropathy.
Methods
Two hundred and thirty-two patients with diabetes mellitus (105 with
cardiac autonomic neuropathy and 127 without cardiac autonomic
neuropathy) and 232 control subjects, matched by gender and age, were
studied. Diagnosis of cardiac autonomic neuropathy was based on the
classic autonomic function tests. All subjects underwent a digital
electrocardiographic recording. Electrocardiographic parameters were
measured using the Modular Electrocardiographic Analysis (MEANS)
program. Left ventricular mass index (LVMi) and global myocardial
performance index (Tei index) of the left ventricle were assessed by
ultrasonography.
Results
The spatial QRS-T angle was higher in the patients with diabetes in
comparison with the control subjects (24.5 +/- 10.7 vs. 9.7 +/- 4.5
degrees, P < 0.001) and in the patients with diabetes and cardiac
autonomic neuropathy than in those without cardiac autonomic neuropathy
(30.1 +/- 11.3 vs. 19.5 +/- 7.1, P < 0.001). No differences were found
in the QT interval between the studied groups. Multivariate linear
regression analysis in subjects with diabetes after controlling for age,
gender, BMI, blood pressure, diabetes duration, HbA(1c), lipids,
microalbuminuria and insulin resistance, demonstrated significant and
independent associations between the spatial QRS-T angle with presence
and severity of cardiac autonomic neuropathy, all parameters of heart
rate variability, LVMi and Tei index.
Conclusions
The spatial QRS-T angle is increased in patients with Type 2 diabetes
who have cardiac autonomic neuropathy, suggesting increased ventricular
arrhythmogenicity, and is associated with the structural and functional
properties of the myocardium. Further research is warranted to evaluate
its role in cardiovascular risk stratification of patients with
diabetes.
Συγγραφείς:
Voulgari, C.
Moyssakis, I.
Perrea, D.
Kyriaki, D. and
Katsilambros, N.
Tentolouris, N.
