What is the clinical evidence from this study?

Study design: Case-Control. Population: Type 2 Diabetes Mellitus (n=130). Intervention: Cardiac autonomic neuropathy vs. Without cardiac autonomic neuropathy. Primary outcome: QT dispersion (QTd) (p=0.02).

What question did this study set out to answer?

This study aims to explore the relationship between QT indices and cardiac autonomic neuropathy in type 2 diabetic patients.

November 19, 2020Diabetology & Metabolic SyndromeOpen Access

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

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Key result

In patients with type 2 diabetes, cardiac autonomic neuropathy was associated with significantly higher QT maximum, QT mean, and QT dispersion compared to those without the condition.

Why the study?

Long QT interval and abnormal QT dispersion are associated with sudden death, motivating an evaluation of their relationship with cardiac autonomic neuropathy in type 2 diabetic patients.

Population

130 type 2 diabetic subjects

Comparison

Patients with CAN vs patients without CAN

Design

Case-control study

Authors

MVMaryam VasheghaniMasih Daneshvari Hospital FSFarzaneh SarvghadiResearch Institute for Endocrine Sciences MBMohammad Reza BeyranvandShahid Beheshti University of Medical Sciences

Discussion

Member takes

Implication

QT indices may aid CAN identification in T2D; leaves open validation for risk stratification or outcomes.

Key Points

This study aims to explore the relationship between QT indices and cardiac autonomic neuropathy in type 2 diabetic patients.
Included 130 diabetic subjects, divided by presence of cardiac autonomic neuropathy.
Used standard and continuous ECG to assess various QT indices.
Diagnosed CAN based on Ewing's tests with specific exclusion criteria.
Abnormal QTc and QTd were found in 11.3% and 28.7% of patients, respectively.
Patients with CAN had higher mean QT max, QT mean, and QTd (P < 0.03).
No significant difference in long QTc between groups, with suggested cutoff points for QTc and QTd as 380 ms and 550 ms.

Study Design

Type

Case-Control (n=130)

Multicenter

Structured PICO

Population

130 adults aged 18-75 years with type 2 diabetes mellitus, with and without cardiac autonomic neuropathy, evaluated in a case-control study.

Comparator

Type 2 diabetic patients without cardiac autonomic neuropathy

Outcome

QT interval indices including QT, QTc, QT min, QT max, QT mean, and QT dispersion (QTd) assessed from standard ECGsurrogate

Main Result

Absolute Event Rate: 69% vs 58%

p-value: p=0.02

In patients with type 2 diabetes, cardiac autonomic neuropathy is associated with higher QT max, QT mean, and QT dispersion, suggesting these indices may help identify autonomic dysfunction.

Limitations

Single center study with a small number of patients, reducing external validity.
Sample size was calculated for QTc and may not be sufficient to examine the relationship of other indices to CAN.
QT intervals were measured manually, introducing potential operator error.
Other factors affecting QT interval, such as electrolyte imbalances, were not evaluated.
Single center with a small number of patients
Sample size was calculated for QTc and may not be sufficient to examine the relationship of other indices to CAN
QT interval was measured and calculated manually, introducing possibility of operator error
Other factors which affect QT interval such as electrolyte imbalance were not evaluated

Cite This Study

Vasheghani et al. (2020) conducted a case-control in Type 2 Diabetes Mellitus (n=130). Cardiac autonomic neuropathy vs. Without cardiac autonomic neuropathy was evaluated on QT dispersion (QTd) (p=0.02). In patients with type 2 diabetes, cardiac autonomic neuropathy was associated with significantly higher QT maximum, QT mean, and QT dispersion compared to those without the condition.

synapsesocial.com/papers/6a545eccf4a790cffe473bd8 https://doi.org/10.1186/s13098-020-00609-0

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The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider