Does glycemic control reverse dispersion of ventricular repolarization in type 2 diabetes?

Miki, Takayuki; Tobisawa, Toshiyuki; Sato, Tatsuya; Tanno, Masaya; Yano, Toshiyuki; Akasaka, Hiroshi; Kuno, Atsushi; Ogasawara, M.; Murase, Hiromichi; Saitoh, Shigeyuki; Miura, Tetsuji

doi:10.1186/s12933-014-0125-8

Cited by 22 publications

(29 citation statements)

References 45 publications

(56 reference statements)

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“…Recent studies have shown that ventricular repolarization is related with age, blood pressure values , and diabetes mellitus (32,17). In our study, the mean age of the blood pressure values were not different among peritoneal dialysis, hemodialysis, and healthy control groups.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Necontrasting

confidence: 41%

“…It was shown that Tp-e/QT was higher in patients with diabetes mellitus compared to the healthy control group (17). In our study group, there were 27 hemodialysis patients with diabetes mellitus and 36 peritoneal dialysis patients with diabetes mellitus.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nementioning

confidence: 52%

“…The Tp-e interval was measured from the peak of the T wave to the end of the T wave (15,16). We defined the end of the T wave as the intersection of the tangent to the down-slope of the T wave and isoelectric line (17). The QT interval was measured from the beginning of the QRS complex to the end of the T wave and corrected for heart rate (QTc) by using Bazett's formula (QTc=QT/RR-2) (18).…”

Section: Electrocardiographic Examinationmentioning

confidence: 99%

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Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Güçlü¹,

Sipahioğlu²,

Icli³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE: Sudden cardiac death and risk of arrhythmia are higher in patients with ESRD. Tp-e/ QT, and Tp-e/QTc are novel and more reliable indexes of ventricular arrhythmogenesis and sudden cardiac death than QTc. The aim of this study was to assess ventricular repolarization in patients with hemodialysis and peritoneal dialysis by using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. MATERIAL and METHODS:A total of 35 healthy controls, 92 hemodialysis patients, and 104 peritoneal dialysis patients were enrolled in the study. The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were calculated from the ECGs of the individuals and compared among groups. RESULTS:QT value was significantly higher in hemodialysis group compared with peritoneal dialysis group (p<0.001) and control group (p<0.001). However a difference was not found comparing QT values between peritoneal dialysis and control groups. Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were significantly higher in hemodialysis and peritoneal dialysis group comparing to control group. However a statistically significant difference was not found while comparing QTc values between peritoneal dialysis and control groups (p:0.081). When all patients of ESRD without DM were compared with the control group, Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were found significantly higher than the healthy control group. The values of Tp-e/QT (p<0.001 r:0.314) and Tp-e/QTc (p:0.018 r:0,187) in all patients with kidney disease were found to show positive correlation with duration of dialysis (month). CONCLUSION:This is the first known study that shows Tp-e/Q, and Tp-e/QTc are higher in hemodialysis and peritoneal dialysis patients. KEy wORDS:Tp-e/QT, Tp-e/QTc, Tp-e, QTc, Dialysis Öz AMAÇ: Ani kardiyak ölüm ve aritmi riski son dönem böbrek yetmezliği hastalarında yüksektir. Tp-e/ QT, ve Tp-e/QTc' nin ventriküler aritmogenezisi ve ani kardiyak ölümü göstermede QTc' den daha değerli olduğu gösterilmiştir. Çalışmada amacımız hemodiyaliz ve periton diyalizi hastalarında Tp-e intervali, Tp-e/QT ve Tp-e/QTc oranını kullanarak ventriküler repolarizasyonu değerlendirmektir. GEREÇ ve yÖNTEMLER:35 sağlıklı kontrol, 92 hemodiyaliz hastası, ve 104 periton diyalizi hastası çalışmaya dahil edildi. Bütün hastaların elektrokardiyografileri çekildi. Tp-e interval, Tp-e/QT ve Tp-e/ QTc oranı elektrokardiyografiden elde edilen verilerle hesaplandı ve gruplar arasında karşılaştırıldı. BULGULAR:QT hemodiyaliz hastalarında periton diyalizi hastalarına (p<0,001) ve sağlıklı kontrollere (p<0,001) göre yüksek saptandı. Ancak QT periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı fark saptanmadı. QTc, Tp-e, Tp-e/QT, ve Tp-e/QTc hemodiyaliz ve periton diyalizi hastalarında sağlıklı kontrollere göre anlamlı yüksek tespit edildi. Bununla birlikte periton diyalizi ve kontrol grupları arasında QTc değerleri arasında farklılık tespit edilmedi (p:0,081). Diyabetik olmayan bütün son dönem böbrek yetmezliği hastaları sağlıklı kontrollerle karşılaştırıldığında QTc, Tp-e, Tp-e/ QT, ve Tp-e/QTc sağlıkl...

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Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Necontrasting

confidence: 41%

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Nementioning

confidence: 52%

Section: Electrocardiographic Examinationmentioning

confidence: 99%

See 1 more Smart Citation

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Güçlü¹,

Sipahioğlu²,

Icli³

et al. 2016

Turk Neph Dial Transpl

View full text Add to dashboard Cite

show abstract

“…Moreover, increased dispersion of ventricular repolarization occurs in diabetic patients5, 6, 7, 8, 10 with an important implication on propensity to develop electrical disturbances 4, 13, 15, 16. To test the possibility that prolonged electrical recovery with hyperglycemia was associated with increased repolarization variability and rhythm disturbances, the degree of temporal dispersion of myocardial repolarization and susceptibility to develop arrhythmias were quantified.…”

Section: Resultsmentioning

confidence: 99%

“…Prolongation of the QT interval and increased dispersion of repolarization have been observed in the diabetic population,4, 5, 6, 7, 8, 9, 10 and these variables, together with intervening comorbidities,11 represent critical substrates for the occurrence of electrical disturbances 4, 12, 13, 14, 15, 16, 17. But whether alterations at the cellular level contribute to protracted electrical recovery and repolarization variability with diabetes remain to be determined.…”

Section: Introductionmentioning

confidence: 99%

Reduction in Kv Current Enhances the Temporal Dispersion of the Action Potential in Diabetic Myocytes: Insights From a Novel Repolarization Algorithm

Meo

Meste

Signore

et al. 2016

JAHA

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BackgroundDiabetes is associated with prolongation of the QT interval of the electrocardiogram and enhanced dispersion of ventricular repolarization, factors that, together with atherosclerosis and myocardial ischemia, may promote the occurrence of electrical disorders. Thus, we tested the possibility that alterations in transmembrane ionic currents reduce the repolarization reserve of myocytes, leading to action potential (AP) prolongation and enhanced beat‐to‐beat variability of repolarization.Methods and ResultsDiabetes was induced in mice with streptozotocin (STZ), and effects of hyperglycemia on electrical properties of whole heart and myocytes were studied with respect to an untreated control group (Ctrl) using electrocardiographic recordings in vivo, ex vivo perfused hearts, and single‐cell patch‐clamp analysis. Additionally, a newly developed algorithm was introduced to obtain detailed information of the impact of high glucose on AP profile. Compared to Ctrl, hyperglycemia in STZ‐treated animals was coupled with prolongation of the QT interval, enhanced temporal dispersion of electrical recovery, and susceptibility to ventricular arrhythmias, defects observed, in part, in the Akita mutant mouse model of type I diabetes. AP was prolonged and beat‐to‐beat variability of repolarization was enhanced in diabetic myocytes, with respect to Ctrl cells. Density of Kv K+ and L‐type Ca2+ currents were decreased in STZ myocytes, in comparison to cells from normoglycemic mice. Pharmacological reduction of Kv currents in Ctrl cells lengthened AP duration and increased temporal dispersion of repolarization, reiterating features identified in diabetic myocytes.ConclusionsReductions in the repolarizing K+ currents may contribute to electrical disturbances of the diabetic heart.

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Wirkung von SGLT-2-Inhibitoren auf eine gestörte ventrikuläre Repolarisation

Jecht

2017

Diabetologe

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Does glycemic control reverse dispersion of ventricular repolarization in type 2 diabetes?

Cited by 22 publications

References 45 publications

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Tp-e/QT and Tp-e/QTc Ratio in Hemodialysis and Peritoneal Dialysis Patients

Reduction in Kv Current Enhances the Temporal Dispersion of the Action Potential in Diabetic Myocytes: Insights From a Novel Repolarization Algorithm

Wirkung von SGLT-2-Inhibitoren auf eine gestörte ventrikuläre Repolarisation

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