Why the study?
Coronary artery disease is the leading cause of death in diabetes mellitus, and new ECG ventricular repolarization parameters can predict mortality and morbidity, motivating examination of these indices in diabetic patients with CAD.
Are ventricular repolarization markers elevated in diabetic patients with noncritical CAD compared to those with normal coronary arteries?
Are ventricular repolarization markers elevated in diabetic patients with noncritical CAD compared to those with normal coronary arteries?
Ventricular repolarization markers, such as the Tp-e interval and Tp-e/QT ratio, are significantly elevated in diabetic patients with noncritical CAD, which may indicate an increased risk for fatal arrhythmic events.
May flag arrhythmic vulnerability in diabetic noncritical CAD; hypothesis-generating for repolarization markers as risk stratifiers.
Background . Diabetes mellitus (DM) is a multisystemic, chronic disease that affects many organs. Coronary artery disease (CAD) is the leading cause of death in patients with DM. The electrocardiogram’s new ventricular repolarization parameters can predict mortality and morbidity. The ventricular repolarization indices were examined in diabetic patients with a CAD diagnosis in this study. Methods . The study group consisted of 84 DM patients (51 males; mean age 58.8 ± 6.6) with noncritical CAD. The control group consisted of 84 DM patients (47 males; mean age 58.7 ± 8.8) with a normal coronary artery. The intervals of QT, QRS, JT, and Tp‐e were all measured. Tp‐e/QT, Tp‐e/QTc, Tp‐e/JT, and Tp‐e/JTc ratios were determined with QTc, QTd, QTdc, and JTc intervals. Results . Heart rate (74.4 ± 13.1 vs. 70.0 ± 13.6 bpm, p : 0.036), QT (381.0 ± 30.3 vs. 368.6 ± 29.1 ms, p : 0.008), QTc (407.5 (359–450) vs. 389 (339–430) ms, p < 0.001), QTd (25.1 ± 6.2 vs. 21.9 ± 9.9 ms, p : 0.013), QTdc (26.7 ± 6.1 vs. 23.1 ± 10.8 ms, p : 0.010), Tp‐e (95.7 ± 12.2 vs. 73.6 ± 9.8 ms, p < 0.001), JT (293.8 ± 22.0 vs. 283.5 ± 30.9 ms, p : 0.014), and JTc (313.6 ± 12.3 vs. 302.4 ± 33.7 ms, p = 0.005) intervals, and Tp‐e/QT (0.25 ± 0.03 vs. 0.20 ± 0.03 ms, p < 0.001), Tp‐e/QTc [0.23 (0.19–2.33) vs. 0.19 (0.14–0.25) ms, p = 0.007], Tp‐e/JT (0.33 ± 0.04 vs. 0.26 ± 0.04 ms, p < 0.001), and Tp‐e/JTc (0.30 ± 0.03 vs. 0.24 ± 0.03 ms, p < 0.001) ratios were all found to be significantly higher in diabetic patients with noncritical CAD. Conclusion . In this study, ventricular repolarization markers on the surface ECG were found to be elevated in diabetic CAD patients. These variables may be related to fatal arrhythmic events. To be sure, large‐scale, randomized controlled trials are required.
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GÜRLER et al. (2022) studied this question.
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