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Cardiac autonomic neuropathy and its correlation with QTc dispersion in type 2 diabetes.
Indian Heart J. 2000 Jul-Aug; 52(4):421-6.IH

Abstract

This study was conducted on 50 patients of diabetes mellitus type 2 and 20 healthy controls to correlate severity of diabetic cardiac autonomic neuropathy with QTc interval and QTc dispersion. Five standard cardiovascular response tests were carried out (i.e. Valsalva ratio, expiration-inspiration ratio, immediate heart rate response to standing, fall of systolic blood pressure on standing and sustained hand grip test) to determine the severity of cardiac autonomic neuropathy by scoring system. QTc dispersion was determined by subtracting heart rate-corrected minimum QTc interval (QTc min) from maximum QT interval (QTc max) from standard electrocardiogram. Severity of cardiac autonomic neuropathy strongly correlated with QTc dispersion (r = 0.760; p = 0.0001). Correlation of severity of cardiac autonomic neuropathy with QTc max and QTc mean was also found but weaker than with QTc dispersion (r = 0.663, r = 0.542, p = 0.0001 each) and no correlation was found with QTc min (r = 0.177; p = 0.17). This shows that QTc dispersion is a better predictor of cardiac autonomic neuropathy than any of above three QTc intervals. QTc max, QTc mean and QTc dispersion were significantly higher (p < 0.001) in diabetics with autonomic neuropathy (450 +/- 23, 423 +/- 22 and 57 +/- 12 msec; n = 30) than without neuropathy (407 +/- 14, 397 +/- 15 and 20 +/- 7 msec; n = 20) and control subjects (408 +/- 20, 399 +/- 19 and 19 +/- 7 msec; n = 20) but QTc min remained same in the three groups (393 +/- 21, 387 +/- 12, 388 +/- 19 msec, respectively) (p > 0.05). Correlation of QTc dispersion was stronger with QTc max (r = 0.781; p < 0.001) than QTc mean (r = 0.625; p = 0.001) but not with QTc min (r = 0.097; p = 1.0) which suggests that regional increase in QT interval due to regional autonomic denervation leads to increased QTc dispersion. Thus, QTc dispersion is a sensitive, non-invasive, simple and cost-effective predictor of cardiac dysautonomia.

Authors+Show Affiliations

Department of Medicine, SP Medical College, Bikaner, Rajasthan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

11084783

Citation

Kumhar, M R., et al. "Cardiac Autonomic Neuropathy and Its Correlation With QTc Dispersion in Type 2 Diabetes." Indian Heart Journal, vol. 52, no. 4, 2000, pp. 421-6.
Kumhar MR, Agarwal TD, Singh VB, et al. Cardiac autonomic neuropathy and its correlation with QTc dispersion in type 2 diabetes. Indian Heart J. 2000;52(4):421-6.
Kumhar, M. R., Agarwal, T. D., Singh, V. B., Kochar, D. K., & Chadda, V. S. (2000). Cardiac autonomic neuropathy and its correlation with QTc dispersion in type 2 diabetes. Indian Heart Journal, 52(4), 421-6.
Kumhar MR, et al. Cardiac Autonomic Neuropathy and Its Correlation With QTc Dispersion in Type 2 Diabetes. Indian Heart J. 2000 Jul-Aug;52(4):421-6. PubMed PMID: 11084783.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac autonomic neuropathy and its correlation with QTc dispersion in type 2 diabetes. AU - Kumhar,M R, AU - Agarwal,T D, AU - Singh,V B, AU - Kochar,D K, AU - Chadda,V S, PY - 2000/11/21/pubmed PY - 2001/2/28/medline PY - 2000/11/21/entrez SP - 421 EP - 6 JF - Indian heart journal JO - Indian Heart J VL - 52 IS - 4 N2 - This study was conducted on 50 patients of diabetes mellitus type 2 and 20 healthy controls to correlate severity of diabetic cardiac autonomic neuropathy with QTc interval and QTc dispersion. Five standard cardiovascular response tests were carried out (i.e. Valsalva ratio, expiration-inspiration ratio, immediate heart rate response to standing, fall of systolic blood pressure on standing and sustained hand grip test) to determine the severity of cardiac autonomic neuropathy by scoring system. QTc dispersion was determined by subtracting heart rate-corrected minimum QTc interval (QTc min) from maximum QT interval (QTc max) from standard electrocardiogram. Severity of cardiac autonomic neuropathy strongly correlated with QTc dispersion (r = 0.760; p = 0.0001). Correlation of severity of cardiac autonomic neuropathy with QTc max and QTc mean was also found but weaker than with QTc dispersion (r = 0.663, r = 0.542, p = 0.0001 each) and no correlation was found with QTc min (r = 0.177; p = 0.17). This shows that QTc dispersion is a better predictor of cardiac autonomic neuropathy than any of above three QTc intervals. QTc max, QTc mean and QTc dispersion were significantly higher (p < 0.001) in diabetics with autonomic neuropathy (450 +/- 23, 423 +/- 22 and 57 +/- 12 msec; n = 30) than without neuropathy (407 +/- 14, 397 +/- 15 and 20 +/- 7 msec; n = 20) and control subjects (408 +/- 20, 399 +/- 19 and 19 +/- 7 msec; n = 20) but QTc min remained same in the three groups (393 +/- 21, 387 +/- 12, 388 +/- 19 msec, respectively) (p > 0.05). Correlation of QTc dispersion was stronger with QTc max (r = 0.781; p < 0.001) than QTc mean (r = 0.625; p = 0.001) but not with QTc min (r = 0.097; p = 1.0) which suggests that regional increase in QT interval due to regional autonomic denervation leads to increased QTc dispersion. Thus, QTc dispersion is a sensitive, non-invasive, simple and cost-effective predictor of cardiac dysautonomia. SN - 0019-4832 UR - https://www.unboundmedicine.com/medline/citation/11084783/Cardiac_autonomic_neuropathy_and_its_correlation_with_QTc_dispersion_in_type_2_diabetes_ DB - PRIME DP - Unbound Medicine ER -