QTc prolongation - a predictor for autonomic neuropathy in diabetic patients
Abstract
Introduction: ECG is an important tool to assess the electrical activity of the heart. It is like any other investigation which can be done on bedside. In this study we have assessed the prolongation of QT interval (QTc), which is a marker for assessment of autonomic neuropathy (AN), in diabetic patients. The probability of autonomic neuropathy is high if the QT interval is prolonged.
Material and Methods: All patients of Type I and Type II Diabetes Mellitus of various age groups studied in the period of 1 year.
Results: As per the discussion QTc can be considered as the predictor of autonomic neuropathy (AN) in a patient if it is prolonged (>440 msec.).
Conclusion:Instead of doing the tests for AN which are more cumbersome a simple QTc can predict AN in a patient. The thumb rule tests definitely stand to grade and assess the AN in a patient, but QTc is inexpensive, more tolerated and easier tool to label the patient as having AN.
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References
2. Kahn JK, Sisson JC, Vinik AI. QT interval prolongation and sudden cardiac death in diabetic autonomic neuropathy. J Clin Endocrinol Metab. 1987 Apr;64(4):751-4. [PubMed]
3. Jermendy G, Tóth L, Vörös P, Koltai MZ, Pogátsa G.. Cardiac autonomic neuropathy and QT interval length. A follow-up study in diabetic patients. Acta Cardiol. 1991;46(2):189-200. [PubMed]
4. Bellavere F, Ferri M, Guarini L, Bax G, Piccoli A, Cardone C, Fedele D. Prolongation of QT period in diabetic AN. A possible role in sudden cardiac death.Br Heart J. 1988 Mar;59(3):379-83. [PubMed]
5. Paul M et.al: Autonomic dysfunction in patients with arythmogenic right ventricular cardiaomyopathy: biochemical evidence of altered signaling pathway. Pacing Clin Electrophysiol. 2014 Feb;37(2):173-8. Epub 2013 Sep 11.
6. Behera D, Das S, Dash RJ, Jindal SK. Cough reflex threshold in diabetes mellitus.Respiration. 1995;62(5):263-8. [PubMed]
7. Wierusz-Wysocka B1, Sadurska K, Lukomska E, Dmochowska H. Usefulness of the measurement of corrected QT (QTc) for the diagnosis of diabetic neuropathy of the autonomic cardiovascular system. Pol Tyg Lek. 1992 Jun 1-8;47(22-23):478-9. [PubMed]
8. Rundgren M, Rosén I, Friberg H. Amplitude-Integrated ECG (a-ECG) predicts outcome after cardiac arrest and induced hypothermia. Intensive Care Med. 2006 Jun;32(6):836-42. Epub 2006 Apr 29. [PubMed]
9. Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J 1982; 285:916-8. [PubMed]
10. Lakhotia M1, Shah PK, Vyas R, Jain SS, Yadav A, Parihar MK.: Clinical dysautonomia in Diabetes Mellitus –a study with seven autonomic reflex function tests . J Assoc Physicians India. 1997 Apr;45(4):271-4.
11. Ewing DJ, Clarke BF. Diagnosis and management of Diabetic autonomic neuropathy. Br Med J (Clin Res Ed). 1982 Oct 2;285(6346):916-8. [PubMed]
12. Chhuttani PN, Chawla LS, Chugh KS, Singh H. Guillain-Barr&Strohl syndrome in India. J Neurol Sci. 1968 Nov-Dec;7(3):581-92. [PubMed]
13. Viswanath, S, McComb, J.M. et al. QT prolongation in patients withType 2 diabetes and microalbuminuria. Clin Auton Res. 2002;12:366–372.
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