Effects of controlled hypoglycaemia on cardiac repolarisation in patients with type 1 diabetes
Effects of controlled hypoglycaemia on cardiac repolarisation in patients with type 1 diabetes
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DOI：
10.1007/s00125-007-0902-y
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发表时间：
2008-03-01
期刊：
影响因子：
8.2
通讯作者：
Perkiomaki, J. S.
中科院分区：
文献类型：
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作者：
Koivikko, M. L.;Karsikas, M.;Perkiomaki, J. S.
目的/假设夜间低血糖可能导致糖尿病患者猝死。然而，目前尚不清楚为什么低血糖会使这些患者容易死亡。 方法 我们使用 T 波和 QRS 复合波形态的新型心电图描述符对 16 名 1 型糖尿病患者和 8 名健康对照者评估了控制低血糖对心脏复极的影响。在正常血糖和低血糖钳夹过程中，通过数字化 12 导联心电图分析表征复极的几个心电图变量。 结果 低血糖不会导致通过列线图方法校正心率的 QT 间期或 QT 离散度发生显着变化。然而，低血糖期间T波的形态发生显着变化。两组的心前导联 T 波振幅和面积均显着下降（p < 0.05 至 p < 0.001）。糖尿病患者的空间 QRS-T 角（R 到 T 的总余弦）（p < 0.05）以及 T 波环的高度和宽度（分别为 p < 0.05 和 p < 0.01）也减小。两组中复极参数的变化与儿茶酚胺水平或心率变异性的变化均未表现出任何显着相关性。结论/解释低血糖导致心脏复极的明显改变，这可能会增加发生心律失常事件的可能性。
Aim/hypothesis Nocturnal hypoglycaemia may contribute to sudden death in diabetic patients. However, it is not well known why hypoglycaemia makes these patients prone to death.Methods We assessed the effects of controlled hypoglycaemia on cardiac repolarisation using novel electrocardiographic descriptors of T-wave and QRS complex morphology in 16 type 1 diabetic patients and eight healthy counterparts. Several electrocardiographic variables characterising repolarisation were analysed from digitised 12-lead electrocardiograms during a euglycaemic and a hypoglycaemic clamp.Results Hypoglycaemia did not result in significant changes either in the QT interval corrected for heart rate by the nomogram method or in QT dispersion. However, the morphology of the T-wave changed significantly during hypoglycaemia. The T-wave amplitude and area in precordial leads decreased significantly in both groups (p < 0.05 to p < 0.001). The spatial QRS-T angle (total cosine R to T) (p < 0.05) and the height and the width of the T-wave loop (p < 0.05 and p < 0.01, respectively) were also reduced in the diabetic patients. The changes in the repolarisation parameters did not exhibit any significant association with changes in catecholamine levels or in heart rate variability in either group.Conclusions/interpretation Hypoglycaemia results in distinct alterations in cardiac repolarisation, which may increase the vulnerability to arrhythmic events.