Dysglycemia and arrhythmias.

Dysglycemia and arrhythmias.
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DOI:
10.4239/wjd.v14.i8.1163
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发表时间:
2023-08-15
影响因子:
4.2
通讯作者:
Liu T
Liu T
中科院分区:
医学3区
文献类型:
--
作者:
Sun DK;Zhang N;Liu Y;Qiu JC;Tse G;Li GP;Roever L;Liu T

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葡萄糖代谢障碍可分为三个独立但相互关联的领域,即高血糖、低血糖和血糖变异性。糖尿病患者强化血糖控制可能会增加低血糖事件和血糖波动的风险。这三种血糖异常状态不仅发生在糖尿病患者中,而且经常出现在其他临床环境中,例如在危重病期间。越来越多的证据集中在这些血糖异常区域与心律失常之间的关系,包括室上性心律失常(主要是房颤)、室性心律失常(恶性室性心律失常和QT间期延长)和心动过缓(心动过缓和心脏传导阻滞)。在实验研究中已经确定了这些血糖异常状态可能引起心律失常的不同机制。为了降低心律失常的风险,最重要的是采用定制的血糖控制策略,以最大限度地降低高血糖、低血糖和血糖变异性的风险。
Disorders in glucose metabolism can be divided into three separate but interrelated domains, namely hyperglycemia, hypoglycemia, and glycemic variability. Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations. These three dysglycemic states occur not only amongst patients with diabetes, but are frequently present in other clinical settings, such as during critically ill. A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias, including supraventricular arrhythmias (primarily atrial fibrillation), ventricular arrhythmias (malignant ventricular arrhythmias and QT interval prolongation), and bradyarrhythmias (bradycardia and heart block). Different mechanisms by which these dysglycemic states might provoke cardiac arr-hythmias have been identified in experimental studies. A customized glycemic control strategy to minimize the risk of hyperglycemia, hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.
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