Diabetic microvascular complications associated with myocardial repolarization heterogeneity evaluated by Tp-e interval and Tp-e/QTc ratio |
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Affiliation: | 1. Medical Care (physical examination) Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;2. Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;3. Department of Endocrinology, Peking University International Hospital, Beijing 102206, China;4. Diabetes Center, Department of Endocrinology, The 306th Hospital of PLA, Beijing, China;5. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China;6. Department of Endocrinology and Metabolism, Peking University People''s Hospital, Beijing 100044, China;1. Department of Epidemiology, Colorado School of Public Health, Univeristy of Colorado Anschutz Medical Campus, Aurora, CO 80045;2. Division of Endocrinology, Diabetes and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045;3. VA Eastern Colorado Health Care System, Denver, CO 80220 |
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Abstract: | IntroductionThe heterogeneity in myocardial repolarization increases the risk of ventricular arrhythmias and sudden death in patients with diabetes mellitus (DM). The Tp-e interval and Tp-e/QTc ratio are found to be useful in the prediction of ventricular arrhythmias. In this study, we aimed to investigate the Tp-e interval and Tp-e/QTc ratio in diabetic patients with and without microvascular complications.Materials and methodsThis cross-sectional observational study included patients with type 2 DM who presented to the endocrinology outpatient clinic. Diabetic microvascular complications were evaluated. The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were also calculated.ResultsA total of 240 patients with type 2 DM (148 patients had microvascular complications) were included in the study. Diabetic neuropathy rate was 30.4%, diabetic nephropathy rate was 38.4%, and diabetic retinopathy rate was 21.7%. Upon comparing patients according to Tp-e/QTc ratio, the median Tp-e/QTc interval of the group of patients with complications was 0.21 (0.19–0.23) and the median Tp-e/QTc ratio of the group of patients without complications was 0.19 (0.18–0.20) (p < 0.001). When patients were grouped according to the presence and severity of retinopathy, the Tp-e/QTc ratio was more prolonged in the proliferative retinopathy group [0.27 (0.23–0.30)] than the non-proliferative retinopathy group [0.20 (0.19–0.22), p < 0.001]. When patients were grouped according to the presence and severity of nephropathy, the Tp-e/QTc ratio was more prolonged in the macroalbuminuria and microalbuminuria group than the normoalbuminuric group [0.25 (0.21–0.30), 0.23 (0.19–0.24), and 0.19 (0.20–0.22), respectively, p = 0.002].ConclusionsOur study is the first to demonstrate the association of the Tp-e interval and Tp-e/QTc ratio with the presence and severity of microvascular complications in patients with type 2 DM. |
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