Agarwal Gaurav, Singh Satish Kumar
Department of Medicine, Nalanda Medical College Hospital, Patna, Bihar, India.
Indian J Endocrinol Metab. 2017 Sep-Oct;21(5):715-718. doi: 10.4103/ijem.IJEM_448_16.
Chronic hyperglycaemia of Type 2 diabetes mellitus causes long term damage to heart resulting in coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), and sudden death from arrhythmias.
To study the prevalence of different types of arrhythmias in T2DM, particularly in association with Cardiac Autonomic Neuropathy (CAN).
A cross-sectional study including 100 patients of Type 2 Diabetes Mellitus (T2DM) presenting with cardiac arrhythmias, was done at our hospital over 2 years. Detailed history along with physical examination and tests for CAN were done. Routine investigations along with echocardiography, stress test, Holter monitoring were done.
Sinus Tachycardia (ST) was the commonest arrhythmia, found in 32% of patients. 20% had Complete Heart Block (CHB), 15% had Sinus Bradycardia (SB), and 15% had Atrial Fibrillation (AF). Ventricular Premature Complex (VPC) was found in 10% and 3% had Atrial Premature Complex (APC). 3% had first degree AV block, whereas 1% had Paroxysmal Supra Ventricular Tachycardia (PSVT), and another 1% had Ventricular Tachycardia (VT). Poorly controlled diabetes and co-morbidities was associated with higher incidence of arrhythmias. 62% of patients had prolonged QTc, majority of which had CAN. Most of the patients responded to standard therapy.
2型糖尿病的慢性高血糖会对心脏造成长期损害，导致冠状动脉疾病（CAD）、心肌梗死（MI）、充血性心力衰竭（CHF）以及心律失常导致的猝死。
研究2型糖尿病（T2DM）中不同类型心律失常的患病率，尤其是与心脏自主神经病变（CAN）相关的情况。
在我院进行了一项为期2年的横断面研究，纳入了100例患有心律失常的2型糖尿病（T2DM）患者。进行了详细的病史采集、体格检查以及CAN检测。还进行了常规检查以及超声心动图、负荷试验、动态心电图监测。
窦性心动过速（ST）是最常见的心律失常，在32%的患者中发现。20%的患者有完全性心脏传导阻滞（CHB），15%的患者有窦性心动过缓（SB），15%的患者有房颤（AF）。室性早搏（VPC）在10%的患者中发现，3%的患者有房性早搏（APC）。3%的患者有一度房室传导阻滞，1%的患者有阵发性室上性心动过速（PSVT），另有1%的患者有室性心动过速（VT）。糖尿病控制不佳和合并症与心律失常的发生率较高相关。62%的患者QTc延长，其中大多数患有CAN。大多数患者对标准治疗有反应。
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