Sun Dong-Kun, Zhang Nan, Liu Ying, Qiu Jiu-Chun, Tse Gary, Li Guang-Ping, Roever Leonardo, Liu Tong
Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Kent and Medway Medical School, Kent CT2 7NT, Canterbury, United Kingdom.
World J Diabetes. 2023 Aug 15;14(8):1163-1177. doi: 10.4239/wjd.v14.i8.1163.
Disorders in glucose metabolism can be divided into three separate but interrelated domains, namely hyperglycemia, hypoglycemia, and glycemic variability. Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations. These three dysglycemic states occur not only amongst patients with diabetes, but are frequently present in other clinical settings, such as during critically ill. A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias, including supraventricular arrhythmias (primarily atrial fibrillation), ventricular arrhythmias (malignant ventricular arrhythmias and QT interval prolongation), and bradyarrhythmias (bradycardia and heart block). Different mechanisms by which these dysglycemic states might provoke cardiac arr-hythmias have been identified in experimental studies. A customized glycemic control strategy to minimize the risk of hyperglycemia, hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.
葡萄糖代谢紊乱可分为三个独立但相互关联的领域，即高血糖、低血糖和血糖变异性。糖尿病患者强化血糖控制可能会增加低血糖事件和血糖波动的风险。这三种血糖异常状态不仅在糖尿病患者中出现，在其他临床环境中也很常见，比如在危重症期间。越来越多的证据聚焦于这些血糖异常领域与心律失常之间的关系，包括室上性心律失常（主要是心房颤动）、室性心律失常（恶性室性心律失常和QT间期延长）以及缓慢性心律失常（心动过缓和心脏传导阻滞）。在实验研究中已经确定了这些血糖异常状态可能引发心律失常的不同机制。制定定制化的血糖控制策略以将高血糖、低血糖和血糖变异性的风险降至最低，对于降低心律失常风险至关重要。
