Premium
Relationship Between Abnormal Microvolt T‐Wave Alternans and Poor Glycemic Control in Type 2 Diabetic Patients
Author(s) -
MOLON GIULIO,
COSTA ALESSANDRO,
BERTOLINI LORENZO,
ZENARI LUCIANO,
ARCARO GUIDO,
BARBIERI ENRICO,
TARGHER GIOVANNI
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00849.x
Subject(s) - medicine , t wave alternans , cardiology , glycemic , diabetes mellitus , body mass index , type 2 diabetes , sudden cardiac death , blood pressure , confounding , type 1 diabetes , qt interval , endocrinology
Background:Abnormal microvolt T‐wave alternans (TWA) predicts the risk of ventricular arrhythmias and sudden cardiac death. Although type 2 diabetes is associated with an increased risk of these events, there is a dearth of available data on microvolt TWA measurements in type 2 diabetic populations .Methods:We studied 59 consecutive type 2 diabetic outpatients without manifest cardiovascular disease (CVD) and 35 non‐diabetic controls who were matched for age, sex, and blood pressure values. Microvolt TWA analysis was performed non‐invasively using the CH‐2000 system during a sub‐maximal exercise with the patient sitting on a bicycle ergometer .Results:The frequency of abnormal TWA was significantly higher in diabetic patients than in controls (25.4 vs 5.7%; P < 0.01). Among diabetic patients, those with abnormal TWA (n = 15) had remarkably higher hemoglobin A1c (HbA1c) (8.1 ± 0.9 vs 7.1 ± 0.8%, P < 0.001) and slightly smaller time‐domain heart rate variability parameters (i.e., RMSSD, root mean square of difference of successive R‐R intervals) than those with normal TWA (n = 44). Gender, age, body mass index, lipids, blood pressure values, cigarette smoking, diabetes duration, microvascular complication status, QTc interval, and current use of medications did not significantly differ between the groups. In multivariate regression logistic analysis, HbA1c (OR 13.6, 95% CI 2.0–89.1; P = 0.0076) predicted abnormal TWA independent of RMSSD values and other potential confounders .Conclusions:Our findings suggest that abnormal TWA is a very common condition (∼25%) among people with type 2 diabetes without manifest CVD and is closely correlated to glycemic control .