Avaliação de Variáveis Eletrocardiográficas de Despolarização e Repolarização Ventricular em Diabetes Mellitus Tipo 1

İnanır, Mehmet; Güneş, Yılmaz; Sıncer, İsa; Erdal, Emrah

doi:10.36660/abc.20180343

“…Besides studying the effect of nano-formulation of quercetin on the electrical contraction of the heart, we also studied its effect on arterial waveform signal which reflects mechanical contraction of the heart. In the present work, MetS was associated with increased systolic and diastolic blood pressure but normal heart rate which is consistent with our previous study ( Inanır et al, 2020 ). Oral administration of nano-formulation of quercetin reduced both systolic and diastolic blood pressure without affecting heart rate.…”

Section: Discussionsupporting

confidence: 94%

A Nano-Pharmaceutical Formula of Quercetin Protects from Cardiovascular Complications Associated with Metabolic Syndrome

Ahmed

¹

,

Hassan

²

,

Azhar

³

et al. 2021

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Metabolic syndrome (MetS) is closely associated with the development of cardiovascular diseases. We recently developed a nano-preparation of the flavonoid quercetin (QU) in a self-nanoemulsifying drug delivery system (SNEDDS). The latter comprised a mixture composed of pumpkin seed oil, D-α-Tocopherol polyethylene glycol 1,000 succinate and polyethylene glycol. The QU SNEDDS preparations exhibited a considerably higher bioavailability compared with the standard quercetin suspension. Here, we investigated whether the quercetin loaded SNEDDS could offer better protection compared with the standard formulation against cardiovascular complications of MetS in rats. MetS was induced by high fructose, high salt and high fat diet for 12 weeks while the nano-preparation or the standard suspension of quercetin was orally administered for the last 6 weeks. Compared to little effect for the standard quercetin suspension (MQ), the treatment of MetS rats with the quercetin loaded SNEDDS (MNQ) virtually abolished the depressant effect of MetS on contractility index (control, 114 ± 4; MetS, 92 ± 3; MQ, 100 ± 2; MNQ, 114 ± 6 1/s) and rate of rise in left ventricular pressure (dP/dtmax) (control, 8,171 ± 274; MetS, 6,664 ± 135; MQ, 6,776 ± 108; MNQ, 7,498 ± 303 mmHg/s). Likewise, the prolongation by MetS of electrocardiographic markers of arrhythmogenesis (QTc, JT, and Tpeak-to-Tend intervals) and concomitant rises in dicrotic notch pressure were preferentially reversed by quercetin nano-preparation. On the other hand, the rises in the isovolumic relaxation constant (Tau, denotes diastolic dysfunction), blood pressure, pulse pressure, and difference between systolic and dicrotic pressure (SDP difference) were equally improved by the two preparations of quercetin. Additionally, no differences were noted in the ability of the two quercetin preparations in abrogating the elevated oxidative (MDA) and inflammatory (TNFα) markers in cardiac tissues of MetS rats. Histopathological, microscopical signs of necrosis, inflammatory cell infiltration, and vascular congestion in MetS hearts were more markedly inhibited by the nano-preparation, compared with the standard preparation of quercetin. In conclusion, the quercetin loaded SNEDDS is evidently more advantageous than the standard preparation of the drug in alleviating functional and histopathological manifestations of cardiac damage incited by MetS.

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“…26,28 In a recent study conducted in adult patients, the heart rate, QTc, QTd, QTdc, Tp-e and JTc intervals, Tp-e/QT ratio and Tp-e/QTc ratio were significantly higher in type 1 diabetes mellituspatients compared to the control group, and a significant correlation was found between the type 1 diabetes mellitus duration and haemoglobin A1c levels and between the QTc, QTd, QTdc, Tp-e and JTc intervals and Tp-e/QT and Tp-e/QTc ratios. 29 Although our patients were children, the QT max, QTd, QTc min, QTc max, QTdc, Tp-e max, Tp-e max/QTc max and JTc data were found to be significantly higher than the control group. However, we did not find a positive correlation between the electrocardiographic data and the type 1 diabetes mellitus duration and haemoglobin A1c levels since our patients were children, and the duration of diagnosis and follow-up was short.…”

Section: Discussioncontrasting

confidence: 59%

Electrocardiographic data of children with type 1 diabetes mellitus

Türe

¹

,

Akın

²

,

Ünal

³

et al. 2021

Cardiol Young

0

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Background: Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death. Aim: The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death. Methods: Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared. Results: The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 ± 1.76 years, and the haemoglobin A1c levels were 9.63% ± 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data. Conclusion: We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.

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“…As predictors of ventricular arrhythmia, a variety of parameters have been investigated [ 33 ]. These parameters are QT, QTc, QTd, JT, JTc, and Tp-e intervals and their ratios (Tp-e/QT, Tp-e/QTc, Tp-e/JT, and Tp-e/JTc) [ 10 , 34 ]. The presence of torsadogenic toxicity has long been linked to QTc prolongation [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Examination of New Electrocardiographic Repolarization Markers in Diabetic Patients with Noncritical Coronary Artery Disease

Gürler

¹

,

İnanır

²

2022

International Journal of Clinical Practice

Self Cite

0

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Background. Diabetes mellitus (DM) is a multisystemic, chronic disease that affects many organs. Coronary artery disease (CAD) is the leading cause of death in patients with DM. The electrocardiogram’s new ventricular repolarization parameters can predict mortality and morbidity. The ventricular repolarization indices were examined in diabetic patients with a CAD diagnosis in this study. Methods. The study group consisted of 84 DM patients (51 males; mean age 58.8 ± 6.6) with noncritical CAD. The control group consisted of 84 DM patients (47 males; mean age 58.7 ± 8.8) with a normal coronary artery. The intervals of QT, QRS, JT, and Tp-e were all measured. Tp-e/QT, Tp-e/QTc, Tp-e/JT, and Tp-e/JTc ratios were determined with QTc, QTd, QTdc, and JTc intervals. Results. Heart rate (74.4 ± 13.1 vs. 70.0 ± 13.6 bpm, p : 0.036), QT (381.0 ± 30.3 vs. 368.6 ± 29.1 ms, p : 0.008), QTc (407.5 (359–450) vs. 389 (339–430) ms, p < 0.001 ), QTd (25.1 ± 6.2 vs. 21.9 ± 9.9 ms, p : 0.013), QTdc (26.7 ± 6.1 vs. 23.1 ± 10.8 ms, p : 0.010), Tp-e (95.7 ± 12.2 vs. 73.6 ± 9.8 ms, p < 0.001 ), JT (293.8 ± 22.0 vs. 283.5 ± 30.9 ms, p : 0.014), and JTc (313.6 ± 12.3 vs. 302.4 ± 33.7 ms, p = 0.005 ) intervals, and Tp-e/QT (0.25 ± 0.03 vs. 0.20 ± 0.03 ms, p < 0.001 ), Tp-e/QTc [0.23 (0.19–2.33) vs. 0.19 (0.14–0.25) ms, p = 0.007 ], Tp-e/JT (0.33 ± 0.04 vs. 0.26 ± 0.04 ms, p < 0.001 ), and Tp-e/JTc (0.30 ± 0.03 vs. 0.24 ± 0.03 ms, p < 0.001 ) ratios were all found to be significantly higher in diabetic patients with noncritical CAD. Conclusion. In this study, ventricular repolarization markers on the surface ECG were found to be elevated in diabetic CAD patients. These variables may be related to fatal arrhythmic events. To be sure, large-scale, randomized controlled trials are required.

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Avaliação de Variáveis Eletrocardiográficas de Despolarização e Repolarização Ventricular em Diabetes Mellitus Tipo 1

Cited by 13 publications

References 37 publications

A Nano-Pharmaceutical Formula of Quercetin Protects from Cardiovascular Complications Associated with Metabolic Syndrome

A Nano-Pharmaceutical Formula of Quercetin Protects from Cardiovascular Complications Associated with Metabolic Syndrome

Electrocardiographic data of children with type 1 diabetes mellitus

Examination of New Electrocardiographic Repolarization Markers in Diabetic Patients with Noncritical Coronary Artery Disease

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