Кардіоваскулярна автономна нейропатія у хворих на цукровий діабет 2-го типу: особливості змін просторового кута QRS-T, коригованого інтервалу QT і дисперсії інтервалу QT
DOI:
https://doi.org/10.24026/1818-1384.2(39).2012.82044Ключові слова:
type 2 diabetes mellitus, cardiovascular autonomic neuropathy, spatial QRS-T angleАнотація
The aim of study was to examine the performance characteristics of the spatial angle QRS-T, corrected QT interval and QT interval dispersion in patients with Type 2 diabetes mellitus and cardiovascular autonomic neuropathy (CAN). The study involved 65 patients with Type 2 diabetes mellitus, including 12 patients without verified CVD, 14 patients with subclinical stage CAN, 18 – functional, 21 – functional-organic stage CAN. Control – the state of the studied parameters in 15 healthy people [similar age, body mass index]. It was established, that the increase of the spatial QRS-T angle in patients with Type 2 diabetes mellitus without diagnosed CVD may indicate a presence of subclinical CAN, which often can not be diagnosed using traditional diagnostic methods. Increased parameters of spatial QRS-T angle are correlated with the presence and/or progression of CAN; statistically significantly and independently correlated with prolongation and dispersion of QT interval.
Посилання
Горохова С. Г. Суточное мониторирование артериального давления. Особенности у больных сахарным диабетом и артериальной гипертонией / С. Г. Горохова, Е. Г. Старостина, А. А. Аракелянц. – М.: НЬЮДИАМЕД, 2006. – 51 с.
Лапач С. Н. Статистические методы в медико-биологических исследваниях с использованием Exel / С. Н. Лапач, А. В. Чубенко, П.Н. Бабич. – К.: Морион, 2000. – 320 с.
Макаров Л. М. Холтеровское монеторирование / Л. М. Макаров. – 2-е изд. – М.: Медпрактика- М, 2003. – 340 c.
Сергієнко В. О. Рання діагностика функціонально-структурних порушень серцево-судинної системи у хворих на цукровий діабет 2-го типу (огляд літератури та власних спостережень) / В. О. Сергієнко, О. О. Сергієнко, А. С. Єфімов // Журн. АМН України.– 2010. – Т. 16, №4. – С. 630-650.
Сергієнко О. О. Автономна нейропатія серця у хворих на цукровий діабет 2-го типу: класифікація, клінічні прояви, діагностика: метод. рекомендації / укл. О. О. Сергієнко, В. О. Сергієнко. – К., 2011. – 22 с.
Associations between electrocardiographic interval durations and coronary artery calcium scores: the Diabetes Heart Study / M.R. Nelson, K.R. Daniel, J.J. Carr [et al.] // Pacing Clin. Electrophysiol. – 2008. – Vol. 31, №3. – P. 314-321. https://doi.org/10.1111/j.1540-8159.2008.00991.x
Cardiac autonomic neuropathy in diabetes mellitus: prevalence, risk factors and utility of corrected QT interval in the ECG for its diagnosis / J.M. Pappachan, J. Sebastian, B.C. Bino [et al.] / / Postgrad. Med. J. – 2008. – Vol. 84, №990. – P. 205-210. https://doi.org/10.1136/pgmj.2007.064048
Determinants of prolonged QT interval and their contribution to sudden death risk in coronary artery disease: the Oregon sudden unexpected death study / S.S. Chugh, K. Reinier, T. Singh [et al.] // Circulation. – 2009. – Vol. 119, №5. – P. 663-670. https://doi.org/10.1161/circulationaha.108.797035
Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments / S. Tesfaye, A.J.M. Boulton, P.J. Dyck [et al.] on behalf of the Toronto Diabetic Neuropathy Expert Group // Diabetes Care. – 2010. – Vol. 33, №10. – P. 2285-2293. https://doi.org/10.2337/dc10-1303
Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial / R. Pop-Busui, G.W. Evans, H.C. Gerstein [et al.] // Diabetes Care. – 2010. – Vol. 33, №7. – P. 1578-1584. https://doi.org/10.2337/dc10-0125
Electrocardiographic alterations during hyperin-sulinemic hypoglycemia in healthy subjects / T. Laitinen, T. Lyyra-Laitinen, H. Huopio [et al.] // Ann. Noninvasive Electrocardiol. – 2008. – Vol. 13, №2. – P. 97-105. https://doi.org/10.1111/j.1542-474x.2008.00208.x
Electrocardiographic predictors of cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-sponsored women's ischemia syndrome evaluation (WISE) study / B. Triola, M.B. Olson, S.E. Reis [et al.] // J. Amer. Coll. Cardiol. – 2005. – Vol. 46, №1. – P. 51-56. https://doi.org/10.1016/j.jacc.2004.09.082
Influence of cardiac autonomic neuropathy on heart rate dependence of ventricular repolarization in diabetic patients / P.E. Valensi, N.B. Johnson, P. Maison-Blanche [et al.] // Diabetes Care. – 2002. – Vol. 25, №5. – P. 918-923. https://doi.org/10.2337/diacare.25.5.918
Prediction of mortality using measures of cardiac autonomic dysfunction in the diabetic and nondiabetic population: the MONICA/KORA Augsburg Cohort study / D. Ziegler, C.P. Zental, S. Perz [et al.] // Diabetes Care. – 2008. – Vol. 31, №3. – P. 556-561. https://doi.org/10.2337/dc07-1615
Prolonged QTc interval predicts mortality in patients with Type 1 diabetes mellitus / P. Rossing, L. Breum, A. Major-Pedersen [et al.] // Diabetic Med. – 2001. – Vol. 18, №3. – P. 199-205. https://doi.org/10.1046/j.1464-5491.2001.00446.x
QT dispersion: comparison between diabetic and non-diabetic individuals and correlation with cardiac autonomic neuropathy / M. Psallas, N. Tentolouris, A. Cokkinos [et al.] // Hellenic J. Cardiol. – 2006. – Vol. 47, №5. – P. 255-262.
QT interval abnormalities are often present at diagnosis in diabetes and are better predictors of cardiac death than ankle brachial pressure index and autonomic function tests / B.S. Rana, P.O. Lim, A.A.O. Naas [et al.] // Heart. – 2005. – Vol. 91, №1. – P. 44-50. https://doi.org/10.1136/hrt.2003.017632
QT interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up / C. Stettler, A. Bearth, S. Allemann [et al.] // Diabetologia. – 2007. – Vol. 50, № 1. – P. 186-194. https://doi.org/10.1007/s00125-006-0483-1
Recommendation for Chamber Quantification: A Report from the American Society of Echocardiography ́s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology // J. Amer. S. EchoCG. – 2005. – Vol. 18, №12. – P. 1447-1448. https://doi.org/10.1016/j.echo.2005.10.005
Soliman E.Z. The relationship between high resting heart rate and ventricular arrhythmogenesis in patients referred to ambulatory 24 h electrocardiographic recording / E.Z. Soliman, M.A. Elsalam, Y. Li // Europace. – 2010. – Vol. 12, №2. – P. 261-265. https://doi.org/10.1093/europace/eup344
Spatial QRS-T angle: association with diabetes and left ventricular performance / C.H. Voulgari, N. Tentolouris, I. Moyssakis [et al.] // Europ. J. Clin. Invest. – 2006. – Vol. 36, №9. – P. 608-613. https://doi.org/10.1111/j.1365-2362.2006.01697.x
The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes a meta-analysis / R.E. Maser, B.D. Mitchell, A.I. Vinik, R. Freeman // Diabetes Care. – 2003. – Vol. 26, №6. – P. 1895-1901. https://doi.org/10.2337/diacare.26.6.1895
The association between the spatial QRS-T angle with cardiac autonomic neuropathy in subjects with Type 2 diabetes mellitus / C. Voulgari, I. Moyssakis, D. Perrea [at al.] // Diabet. Med. – 2010. – Vol. 27, №12. – P. 1420-1429. https://doi.org/10.1111/j.1464-5491.2010.03120.x
The Electro-Mechanical window: a risk marker for Torsade de Pointes in a canine model of drug induced arrhythmias / H.J. van der Linde, B. Van Deuren, Y. Somers [et al.] // Bri. J. Pharmacol. – 2010. – Vol. 161, №7. – P. 1444-1454. https://doi.org/10.1111/j.1476-5381.2010.00934.x
Vinik A.I. Diabetic cardiovascular autonomic neuropathy / A.I. Vinik, D. Ziegler // Circulation. – 2007. – Vol. 115, №3. – P. 387-397. https://doi.org/10.1161/circulationaha.106.634949
Voulgari C. Assessment of the spatial QRS-T angle by vectorcardiography: current data and perspectives / C. Voulgari, N. Tentolouris // Cur. Cardiol. Rev. – 2009. – Vol. 5, №4. – P. 251-262. https://doi.org/10.2174/157340309789317850
World Medical Association Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. – WMA, 2004. – 32 p.
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