Prevalence of QT prolongation and associated LVEF changes in diabetic patients over a four-year retrospective time period

Abstract

Aim: To evaluate the prevalence and longitudinal changes of prolonged QTc in DM patients admitted to our community hospital, and to determine, if any, its correlation with changes of left ventricular ejection fraction (LVEF). Methods: A retrospective chart review of patients with Type 1 (T1DM) and Type 2 (T2DM) with at least two admissions during a four-year period was performed to identify QTc interval, and LVEF, as measured on transthoracic echocardiogram. Changes in QTc and LVEF between patient hospital admissions were compared. Results: A prolonged QTc interval was found in 66.7% (n = 24) of type 1 and 51.3% (n = 154) type 2 diabetic patients. The QTc interval is progressively increased in both type 1 and type 2 diabetes during follow-up, although it did not reach statistical significance. A total of 62% patients (23 out 37 patients) had a reduction of LVEF during follow-up. Conclusion and Discussion: High prevalence of QTc prolongation was confirmed in hospitalized patients with in both T1DM and T2DM. Significant reduction of LVEF correlated with QTc prolongation over a mean of 17.3 months in T2DM patients, and may have implications for interventions.Abbreviations CHF: Congestive heart failure LVEF: Left ventricular ejection fraction

Changes in QTc and PR Intervals among Indian Type 2 Diabetes Patients with Respect to Prevailing Glycated Hemoglobin Level: a Retrospective Analysis

“…In China, the prevalence ranged between 17.1 and 30.1% in crosssectional studies conducted among 2904 and 3156 patients, respectively [41]. Moreover, significantly higher rates were reported in the UK (44.1%) and the USA (51.3%) [18,42]. Differences in sample sizes and the applied formulas to estimate QTc may explain such variations.…”

Suppression of hERG K+ current and cardiac action potential prolongation by 4-hydroxynonenal via dual mechanisms

“…In fact, treatment with antioxidants was protective in the doxorubicin-induced cardiotoxicity model [30] . It is of interest that a higher prevalence of QT prolongation has been also reported in chronic metabolic disease patients with both type-1 and − 2 diabetes [31] . Considering the critical role of I hERG (I Kr ) in cardiac repolarization, we cautiously suggest both acute and chronic inhibition of hERG by 4-HNE may partly contribute to the increased proarrhythmic risk in oxidative stress-related diseases.…”

A basis for human QT interval prolongation and arrhythmia risk in type 2 diabetes?

“…In the same study, >60% of diabetic patients exhibited a modest but significant reduction in left ventricular ejection fraction between first and second admissions (Lu et al . ). In preclinical experiments, potassium channel current reduction has been reported in ventricular myocytes from type 2 diabetic ( db/db ) male but not female mice at 12 weeks of age (Shimoni et al .…”

“…Preclinical and clinical data suggest that diabetes influences the heart and may be associated with cardiac repolarization abnormalities and pro-arrhythmia. For example, a recent (2017) retrospective review of patients admitted to hospital at least twice in a 4 year period with type 1 or 2 diabetes found prolonged rate-corrected (QT c ) QT intervals in ß67% of type 1 and ß51% of type 2 patients (Lu et al 2017). In the same study, >60% of diabetic patients exhibited a modest but significant reduction in left ventricular ejection fraction between first and second admissions (Lu et al 2017).…”

“…For example, a recent (2017) retrospective review of patients admitted to hospital at least twice in a 4 year period with type 1 or 2 diabetes found prolonged rate-corrected (QT c ) QT intervals in ß67% of type 1 and ß51% of type 2 patients (Lu et al 2017). In the same study, >60% of diabetic patients exhibited a modest but significant reduction in left ventricular ejection fraction between first and second admissions (Lu et al 2017). In preclinical experiments, potassium channel current reduction has been reported in ventricular myocytes from type 2 diabetic (db/db) male but not female mice at 12 weeks of age (Shimoni et al 2004); this suggests that type 2 diabetes in mice is associated with sex-specific K + channel remodelling.…”