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Several studies have focused on the identification of patients at risk of sudden cardiac death, which is mostly due to depolarization and repolarization impairment. The measurement of QT interval indicates the total duration of ventricular myocardial depolarization and repolarization. Localized repolarization data can be obtained easily from the standard 12lead electrocardiogram (ECG), a non-invasive method extensively used as a tool for cardiovascular risk assessment. [1,2] Non-uniform myocardial repolarization time may result from inhomogeneity, variation of action potential duration between the individual leads of the 12-lead ECG, or localized delay in activation due to slow conduction or altered conduction pathways. To ensure the recording of the earliest depolarization at the latest repolarization of the ventricular myocardium, the maximum QT interval should be measured from the beginning of the earliest QRS complex to the end of the latest T wave from all leads of a simultaneous 12-lead ECG. Nevertheless, the QT interval may reflect increased inhomogeneity of myocardial repolarization, resulting from delayed repolarization in some areas of the myocardium, and it can be caused by a uniform increase in action potential duration. A measure that can help differentiate between these two conditions is the QT dispersion. Using both the QT prolongation and the QT dispersion the individual lead variation and the interlead variation provide a measure of repolarization heterogeneity. [3] The QT interval prolongation has been proposed as a marker of cardiovascular risk in the clinical setting and it has also been particularly associated with arrhythmias, sudden death and poor survival in apparently healthy subjects. [4,5] As for diabetic subjects, although some cross-sectional studies suggest that glycemic control, ischemic heart disease, and blood pressure, among other risk factors, are associated with the QT interval prolongation, its pathogenesis remains unclear. [6,8] Also, and increased mortality in newly diagnosed type 2 diabetes patients has been associated with QT interval prolongation. [9,10] The aim of this study was to estimate the prevalence of QTc interval prolongation in diabetic and non-diabetic subjects, as well as to evaluate cross-sectionally and prospectively the associated risk factors of QTc interval prolongation and its clinical implications in subjects

Electrocardiographic QT Interval Prolongation in Subjects With and Without Type 2 Diabetes – Risk Factors and Clinical Implications