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ŞİMŞEK E. Tip 2 diabetes mellitus hastalarında hipergliseminin kardiyak repolarizasyon parametrelerine akut etkileri. EGE TIP DERGISI 2020. [DOI: 10.19161/etd.698693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Diabetes mellitus (DM) has been known for many years to be associated with poor cardiovascular prognosis. Due to the sensitive neuropathy, the coronary artery disease in diabetic patients is frequently asymptomatic. Also twelve leads resting ECG can be within normal limits even in an advanced stage of coronary artery disease. Therefore in addition to the standard ECG other electrocardiographic procedures started to be studied in order to find some typical signs of myocardial damages caused by DM. Repeatedly reported results showed in DM patients without cardiovascular complications the tachycardia, shortening of the QRS and QT intervals, increase of the dispersion of QT interval, decreased amplitudes of depolarization waves, shortened activation time of ventricular myocardium and a flattening of T waves confirmed by the lower value of maximum and minimum in repolarization body surface isopotential maps. Most of these changes are even more pronounced in patients with cardiac autonomic neuropathy. Comparison with similar ECG changes in other diseases suggests that the electrocardiographic changes in DM patients are not specific and that they are particularly caused by an increased tone of the sympathetic nervous system what was indirectly confirmed by the heart rate variability findings in these patients.
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Affiliation(s)
- O. KITTNAR
- Institute of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Adebayo RA, Ikwu AN, Balogun MO, Akintomide AO, Ajayi OE, Adeyeye VO, Mene-Afejuku TO, Bamikole OJ, Ogunyemi SA, Ajibare AO, Oketona OA. Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases. Vasc Health Risk Manag 2015; 11:353-9. [PMID: 26170685 PMCID: PMC4492626 DOI: 10.2147/vhrm.s81106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Facilities for Holter electrocardiography (ECG) monitoring in many Nigerian hospitals are limited. There are few published works in Nigeria on the use of 24-hour Holter ECG in cardiac arrhythmic evaluation of patients with cardiovascular diseases. OBJECTIVE To study the clinical indications, arrhythmic pattern, and heart rate variability (HRV) among subjects referred for 24-hour Holter ECG at our Cardiac Care Unit. METHODS Three-hundred and ten patients (134 males and 176 females) were studied consecutively over a 48-month period using Schiller type (MT-101) Holter ECG machine. RESULTS Out of the 310 patients reviewed, 134 were males (43.2%) and 176 were females (56.8%). The commonest indication for Holter ECG was palpitation followed by syncope in 71 (23%) and 49 (15.8%) of subjects, respectively. Premature ventricular complex and premature atrial complex were the commonest types of arrhythmia in 51.5% and 15% subjects, respectively. Ventricular arrhythmia was more prevalent in dilated cardiomyopathy patients (85.7%). The HRV of subjects with palpitation, stroke, and diabetes mellitus with autonomic neuropathy, using standard deviation of normal to normal intervals average (milliseconds), were 107.32±49.61, 79.15±49.15, and 66.50±15.54, respectively. The HRV, using standard deviation of averages of normal to normal intervals average (milliseconds), of patients with palpitation, stroke, and diabetes mellitus with autonomic neuropathy were 77.39±62.34, 57.82±37.05, and 55.50±12.71, respectively. CONCLUSION Palpitation and syncope were the commonest indications for Holter ECG among our subjects. The commonest arrhythmic patterns were premature ventricular complex and premature atrial complex, with ventricular arrhythmia being more prevalent in dilated cardiomyopathy. There was a reduction in HRV in patients with stroke and diabetic autonomic neuropathy.
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Affiliation(s)
- Rasaaq Ayodele Adebayo
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Amanze Nkemjika Ikwu
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Michael Olabode Balogun
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Anthony Olubunmi Akintomide
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Olufemi Eyitayo Ajayi
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Victor Oladeji Adeyeye
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Tuoyo Omasan Mene-Afejuku
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Olaniyi James Bamikole
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Suraj Adefabi Ogunyemi
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Adeola Olubunmi Ajibare
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
| | - Omolola Abiodun Oketona
- Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria
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