Prolonged QTc interval predicts mortality in patients with Type 1 diabetes mellitus

Abstract

QTc prolongation, but not increased QT dispersion, is an independent marker of increased mortality in patients with Type 1 diabetes mellitus.

QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up

“…To our knowledge, this is the first study to prospectively assess the role of QT c and rHR in both types of diabetes within the same study framework. Its findings confirm the prognostic value of QT c as an independent risk factor for all-cause mortality in type 1 diabetes [5,[28][29][30]. In addition to the results of Rossing et al [5], the present…”

“…Moreover, it also reproduced the findings of Sawicki and colleagues, which were made in subjects with nephropathy [28] in a more general sample of subjects with type 1 diabetes. The HR for overall mortality found in the present analysis was comparable to that in Rossing's report [5], but tended to be lower than the risk ratio found in subjects with overt nephropathy [28] (1.10 and 1.47 per 10 ms, respectively). Earlier reports have suggested that the association between QT c and cardiovascular disease was stronger in male than in female subjects with type 1 diabetes [30].…”

“…In an effort to identify easily available and reliable predictors for cardiovascular risk and mortality in diabetes mellitus, the evaluation of parameters reflecting myocardial ventricular repolarisation has been of particular interest. In subjects with type 1 diabetes, prolongation of the QT interval corrected for heart rate (QT c ) and heart rate variability have both been shown to be associated with increased risk of arrhythmia and death, whereas QT dispersion has been suggested to be less reliable [5]. However, the association between QT c and cardiovascular mortality in type 2 diabetes is controversial.…”

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

“…Clinically, there are several inherited and acquired conditions, including diabetes,4, 5, 9, 10, 12, 13 that are characterized by prolongation of the QT interval, a factor that enhances the incidence of ventricular arrhythmia and sudden cardiac death 14. 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.…”

“…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.…”