JOMPAC

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Evaluation of electrocardiographic arrhythmogenicity markers in patients with type 2 diabetes mellitus
Aims: Diabetes mellitus (DM) is a chronic disease that progresses with hyperglycemia and the proinflammatory process. The most common complication of DM is cardiovascular disease, and it is known that the risk of arrhythmia increases in patients with DM. The aim of our study was to evaluate the correlation of electrocardiographic arrhythmogenicity markers with HbA1c and fasting blood glucose.
Methods: The study included 77 type 2 DM patients and 76 healthy individuals as a control group. Body mass index, HbA1c value, and fasting blood glucose level were recorded for all patients. Corrected QT (QTc), T peak-T end intervals (Tp-e), and Tp-e/QTc values were calculated from 12-lead electrocardiography (ECG). The results were evaluated statistically.
Results: The Tp-e interval (p<0.001), QTc interval (p<0.05), and Tp-e/QTc ratio (p<0.001) were significantly prolonged within the DM group compared to the control group.
Conclusion: ECG, an inexpensive and reliable diagnostic method, can be used to evaluate the risk of arrhythmia in DM patients. This study concluded that QTc, Tp-e interval, and Tp-e/QTc ratio are markers that can be used to predict arrhythmia risk in DM patients.


1. Stumvoll M, Goldstein BJ, van Haeften TW. Type 2diabetes: principles of pathogenesis and therapy. Lancet.2005;365(9467):1333-1346.
2. Rivellese AA, Riccardi G, Vaccaro O. Cardiovascular risk inwomen with diabetes. Nutr Metab Cardiovasc Dis. 2010;20(6):474-480.
3. Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: astatement by the American Diabetes Association. Diabetes Care.2005;28(4):956-962.
4. Verrier RL, Antzelevitch C. Autonomic aspects ofarrhythmogenesis: the enduring and the new. Curr Opin Cardiol.2004;19(1):2-11.
5. Kluppelholz B, Thorand B, Koenig W, et al. Association ofsubclinical inflammation with deterioration of glycaemiabefore the diagnosis of type 2 diabetes: the KORA S4/F4 study.Diabetologia. 2015;58(10):2269-2277.
6. Aburisheh K, AlKheraiji MF, Alwalan SI, et al. Prevalence of QTprolongation and its risk factors in patients with type 2 diabetes.BMC Endocr Disord. 2023;23(1):50.
7. Cox AJ, Azeem A, Yeboah J, et al. Heart rate-corrected QT intervalis an independent predictor of all-cause and cardiovascularmortality in individuals with type 2 diabetes: the Diabetes HeartStudy. Diabetes Care. 2014;37(5):1454-1461.
8. Naas AA, Davidson NC, Thompson C, et al. QT and QTcdispersion are accurate predictors of cardiac death in newlydiagnosed non-insulin dependent diabetes: cohort study. BMJ.1998;316(7133):745-746.
9. Tokatli A, Kili&ccedil;aslan F, Alis M, Yiginer O, Uzun M. ProlongedTp-e Interval, Tp-e/QT Ratio and Tp-e/QTc Ratio in Patientswith Type 2 Diabetes Mellitus. Endocrinol Metab (Seoul).2016;31(1):105-112.
10. Kuzu F. The effect of type 2 diabetes on electrocardiographicmarkers of significant cardiac events. Pak J Med Sci.2018;34(3):626-632.
11. Yamaguchi M, Shimizu M, Ino H, et al. T wave peak-to-endinterval and QT dispersion in acquired long QT syndrome: a newindex for arrhythmogenicity. Clin Sci. 2003;105(6):671-676.
12. Dahlberg P, Diamant UB, Gilljam T, Rydberg A, Bergfeldt L.QT correction using Bazett&rsquo;s formula remains preferable in longQT syndrome type 1 and 2. Ann Noninvasive Electrocardiol.2021;26(1):e12804.
13. Svane J, Pedersen-Bjergaard U, Tfelt-Hansen J. Diabetes and theRisk of Sudden Cardiac Death. Curr Cardiol Rep. 2020;22(10):112.
14. Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalenceand risk factors for prolonged QT interval and QT dispersion inpatients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744.
15. Stern K, Cho YH, Benitez-Aguirre P, et al. QT interval, correctedfor heart rate, is associated with HbA1c concentration andautonomic function in diabetes. Diabet Med. 2016;33(10):1415-1421.
16. Ninkovic VM, Ninkovic SM, Miloradovic V, et al. Prevalenceand risk factors for prolonged QT interval and QT dispersion inpatients with type 2 diabetes. Acta Diabetol. 2016;53(5):737-744.doi:10.1007/s00592-016-0864-y
17. Agarwal G, Singh SK. Arrhythmias in type 2 diabetes mellitus.Indian J Endocrinol Metab. 2017;21(5):715-718.
18. Castro-Torres Y, Carmona-Puerta R, Katholi RE. Ventricularrepolarization markers for predicting malignant arrhythmias inclinical practice. World J Clin Cases. 2015;16:3(8):705-720.
19. Ardahanlı İ, Celik M. Comparison of Tp-e interval, QTc intervaland Tp-e/QTc ratios between non-diabetic and prediabeticpopulation. Ann Med Res. 2020; 27(12):3117-3122.
20. Fox CS, Sullivan L, D&rsquo;Agostino RB Sr, Wilson PW; FraminghamHeart Study. The significant effect of diabetes duration oncoronary heart disease mortality: the Framingham Heart Study.Diabetes Care. 2004;27(3):704-708.
21. Kishi S, Gidding SS, Reis JP, et al. Association of insulin resistanceand glycemic metabolic abnormalities with LV structure andfunction in middle age: the CARDIA Study. JACC CardiovascImaging. 2017;10(2):105-114.
22. Haffner SM, Mitchell BD, Stern MP, Hazuda HP. Macrovascularcomplications in Mexican Americans with type II diabetes.Diabetes Care. 1991;14(7):665-671.
23. Waheed S, Dawn B, Gupta K. Association of corrected QTinterval with body mass index, and the impact of this associationon mortality: results from the third national health and nutritionexamination survey. Obes Res Clin Pract. 2017;11(4):426-434.
24. Bağcı A, Aksoy F. The frontal plane QRS-T angle may affect ourperspective on prehypertension: a prospective study. Clin ExpHypertens. 2021;43(5):402-407.
25. Csige I, Ujv&aacute;rosy D, Szab&oacute; Z, et al. The impact of obesity on thecardiovascular system. J Diabetes Res. 2018;2018:3407306.
26. Lambert EA, Straznicky NE, Dixon JB, Lambert GW. Shouldthe sympathetic nervous system be a target to improvecardiometabolic risk in obesity? Am J Physiol Heart CirculatoryPhysiol. 2015;309(2):H244-H58.
Volume 4, Issue 5, 2023
Page : 431-435
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