Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, 50 Pervomayskaya Street, 167982 Syktyvkar, Russia.
Department of Therapy, Institute of Medicine, Pitirim Sorokin Syktyvkar State University, Syktyvkar, Russia.
Can J Physiol Pharmacol. 2021 Oct;99(10):1097-1101. doi: 10.1139/cjpp-2020-0743. Epub 2021 May 5.
Diabetes mellitus (DM) is associated with increased risk of sudden cardiac death, but its role in arrhythmogenesis is not clear. We evaluated contributions of DM duration and hyperglycemia level to development of proarrhythmic electrophysiological changes in the experimental ischemia/reperfusion model. Ventricular epicardial 64-lead mapping and arrhythmia susceptibility burst-pacing testing were performed in 43 healthy and 55 diabetic (alloxan model) anesthetized rabbits undergoing 15 min left anterior descending coronary artery occlusion, followed by 15 min reperfusion. During ischemia, arrhythmia inducibility did not differ between the groups, but the number of reperfusion ventricular tachycardias and (or) fibrillations (VT/VFs) were higher in the DM group (14 out of 55) as compared with control (3 out of 43, = 0.017). In the diabetic animals, both DM duration and glucose concentration were associated with reperfusion VT/VF development in univariate logistic regression analysis (odds ratio (OR) 1.058, 95% confidence interval (CI) 1.025-1.092, < 0.001; and OR 1.119, 95% CI 1.045-1.198, = 0.001, respectively). Only the DM duration, however, remained an independent predictor of reperfusion VT/VF in multivariate logistic regression analysis (OR 1.060, 95% CI 1.006-1.117, = 0.029). Among mapping parameters, DM duration was associated with the prolongation of total ventricular activation duration (regression coefficient 0.152, 95% CI 0.049-0.255, = 0.005) and activation-repolarization intervals (ARIs) (regression coefficient 0.900, 95% CI 0.315-1.484, = 0.003). The prolonged ARI was the only mapping characteristic predicting reperfusion VT/VF development (OR 1.028, 95% CI 1.009-1.048, = 0.004). The DM duration-dependent prolongation of ventricular repolarization presents a link between DM development and reperfusion VT/VF inducibility.
糖尿病（DM）与心源性猝死风险增加相关，但DM 在心律失常发生中的作用尚不清楚。我们评估了 DM 持续时间和高血糖水平对实验性缺血/再灌注模型中致心律失常电生理变化发展的贡献。在接受 15 分钟左前降支冠状动脉闭塞，随后再灌注 15 分钟的麻醉兔中，进行了 43 只健康兔和 55 只糖尿病兔（链脲佐菌素模型）的心室心外膜 64 导联标测和心律失常易感性猝发起搏测试。在缺血期间，两组的心律失常诱导率无差异，但在 DM 组（55 只中的 14 只）与对照组（43 只中的 3 只）相比，再灌注室性心动过速和（或）纤颤（VT/VF）的数量更高（ = 0.017）。在糖尿病动物中，单变量逻辑回归分析显示，DM 持续时间和葡萄糖浓度均与再灌注 VT/VF 发展相关（比值比（OR）1.058，95%置信区间（CI）1.025-1.092， < 0.001；和 OR 1.119，95% CI 1.045-1.198， = 0.001）。然而，只有 DM 持续时间在多变量逻辑回归分析中仍然是再灌注 VT/VF 的独立预测因子（OR 1.060，95% CI 1.006-1.117， = 0.029）。在映射参数中，DM 持续时间与总心室激活持续时间的延长相关（回归系数 0.152，95% CI 0.049-0.255， = 0.005）和激活-复极间隔（ARIs）（回归系数 0.900，95% CI 0.315-1.484， = 0.003）。延长的 ARI 是唯一预测再灌注 VT/VF 发展的映射特征（OR 1.028，95% CI 1.009-1.048， = 0.004）。DM 持续时间依赖性心室复极延长在 DM 发展与再灌注 VT/VF 易感性之间建立了联系。
