Miki Takayuki, Tobisawa Toshiyuki, Sato Tatsuya, Tanno Masaya, Yano Toshiyuki, Akasaka Hiroshi, Kuno Atsushi, Ogasawara Makoto, Murase Hiromichi, Saitoh Shigeyuki, Miura Tetsuji
Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1 West-16, Sapporo 060-8543, Chuo-ku, Japan.
Cardiovasc Diabetol. 2014 Aug 21;13:125. doi: 10.1186/s12933-014-0125-8.
Abnormal ventricular repolarization is a predictor of cardiovascular mortality. In this study, we tested the hypothesis that glycemic control reverses abnormal ventricular repolarization in patients with type 2 diabetes.
We analyzed longitudinal changes in repolarization indices of electrocardiograms in retrospectively enrolled 44 patients with type 2 diabetes and 44 age-matched healthy subjects.
In the diabetic group, BMI was greater, levels of HbA1c (10.0 ± 1.6 vs. 5.6 ± 0.3%) and triglyceride were higher and level of HDL cholesterol was lower than those in the control group. Although mean QTc intervals were similar (413.6 ± 18.5 vs. 408.3 ± 22.7 ms), QT dispersion (41.8 ± 15.4 vs. 28.7 ± 7.7 ms) and Tpeak-Tend in lead V5 (83.6 ± 13.6 vs. 71.3 ± 10.3 ms) were significantly longer in the diabetic group than in the control group, indicating increased heterogeneity of ventricular repolarization in type 2 diabetes. During follow-up of 36 patients in the diabetic group for 787 ± 301 days, HbA1c level decreased to 7.3 ± 1.6%, while BMI did not significantly change. In contrast to HbA1c, QT dispersion (45.8 ± 15.0 ms) and Tpeak-Tend in lead V5 (83.6 ± 10.6 ms) were not significantly reduced during the follow-up period. There was no correlation between the change in HbA1c and the change in QT dispersion or Tpeak-Tend.
Increased heterogeneity of ventricular repolarization in type 2 diabetic patients was not reduced during the relatively short follow-up period despite significantly improved glycemic control.
心室复极异常是心血管疾病死亡率的一个预测指标。在本研究中，我们检验了血糖控制可逆转2型糖尿病患者心室复极异常这一假设。
我们分析了回顾性纳入的44例2型糖尿病患者和44例年龄匹配的健康受试者心电图复极指标的纵向变化。
糖尿病组的体重指数更高，糖化血红蛋白水平（10.0±1.6% 对5.6±0.3%）和甘油三酯水平更高，高密度脂蛋白胆固醇水平低于对照组。虽然平均QTc间期相似（413.6±18.5毫秒对408.3±22.7毫秒），但糖尿病组的QT离散度（41.8±15.4毫秒对28.7±7.7毫秒）和V5导联的T波峰 - T波末间期（83.6±13.6毫秒对71.3±10.3毫秒）显著长于对照组，表明2型糖尿病患者心室复极的异质性增加。在糖尿病组36例患者787±301天的随访期间，糖化血红蛋白水平降至7.3±1.6%，而体重指数无显著变化。与糖化血红蛋白不同，随访期间QT离散度（45.8±15.0毫秒）和V5导联的T波峰 - T波末间期（83.6±10.6毫秒）未显著降低。糖化血红蛋白的变化与QT离散度或T波峰 - T波末间期的变化之间无相关性。
尽管血糖控制显著改善，但在相对较短的随访期内，2型糖尿病患者心室复极异质性增加的情况并未减轻。
