QT interval abnormalities are often present at diagnosis in diabetes and are better predictors of cardiac death than ankle brachial pressure index and autonomic function tests
QT interval abnormalities are often present at diagnosis in diabetes and are better predictors of cardiac death than ankle brachial pressure index and autonomic function tests
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DOI：
10.1136/hrt.2003.017632
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发表时间：
2005-01-01
期刊：
影响因子：
5.7
通讯作者：
Struthers, AD
中科院分区：
文献类型：
--
作者：
Rana, BS;Lim, PO;Struthers, AD
目的：研究非胰岛素依赖型糖尿病患者经心率校正的最大QT间期（QTc）和QT离散度（QTD）与心脏性死亡的关系，并将QT异常与其他死亡预测因素进行比较（踝臂压力指数（ABPI）和自主神经功能测试）预测心脏性死亡的能力。本文分析了192例非胰岛素依赖型糖尿病患者的QT间期、深呼吸和站立时心率（RR）变化及ABPI。结果：平均（SD）随访时间为12.7（3.2）年（范围1.2 - 17.1年）。有48例死亡，其中26例是心脏病。QTc和QTd是随访期间心源性死亡率的独立显著预测因子（p< 0.001）。QT参数的预测性上级优于ABPI和RR间期分析的预测性。QT参数的时间变化表明，平均绝对QT参数是一个显着的预测心脏性死亡（p< 0.001），而随着时间的推移QT参数的个体内变化是没有predicter.Conclusion：QT异常似乎存在于糖尿病的诊断点，并没有出现改变，然后和随后的心脏性死亡之间。此外，QT间期分析在识别糖尿病患者的心脏性死亡高风险方面上级ABPI和RR间期。
Objectives: To study serial measures of maximum QT interval corrected for heart rate (QTc) and QT dispersion (QTD) and their association with cardiac mortality patients with non-insulin dependent diabetes and to compare QT abnormalities with other mortality predictors ( ankle brachial pressure index (ABPI) and autonomic function tests) in their ability to predict cardiac death.Setting: Teaching hospital.Methods and patients: QT interval analysis, heart rate (RR) variation in response to deep breathing and standing, and ABPI were analysed in 192 patients with non-insulin dependent diabetes. Cardiac death was the primary end point.Results: Mean (SD) follow up was 12.7 (3.2) years ( range 1.2 - 17.1 years). There were 48 deaths, of which 26 were cardiac. QTc and QTD were individually significant predictors of cardiac mortality throughout the follow up period ( p< 0.001). The predictability of QT parameters was superior to the predictability of ABPI and RR interval analysis. Temporal changes in QT parameters showed that the mean absolute QT parameter was a significant predictor of cardiac death ( p< 0.001), whereas an intraindividual change in QT parameter over time was not predictive.Conclusion: QT abnormalities seem to exist at the point of diagnosis of diabetes and do not appear to change between then and the subsequent cardiac death. Furthermore, the analysis of QT interval is superior to ABPI and the RR interval in identifying diabetic patients at high risk of cardiac death.