Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-17T13:20:10.664Z Has data issue: false hasContentIssue false
  • English
  • Français

Electrocardiographic data of children with type 1 diabetes mellitus

Published online by Cambridge University Press:  02 November 2021

Mehmet Türe Open the ORCID record for Mehmet Türe [Opens in a new window] ,
Alper Akın Open the ORCID record for Alper Akın [Opens in a new window] ,
Edip Unal Open the ORCID record for Edip Unal [Opens in a new window] ,
Ahmet Kan  and
Suat Savaş
Mehmet Türe*
Affiliation:
Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
Alper Akın
Affiliation:
Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
Edip Unal
Affiliation:
Department of Pediatric Endocrinology, Dicle University Hospital, Diyarbakır, Turkey
Ahmet Kan
Affiliation:
Department of Pediatric Allergy and İmmunology, Dicle University Hospital, Diyarbakır, Turkey
Suat Savaş
Affiliation:
Department of Pediatric, Dicle University Hospital, Diyarbakır, Turkey
*
Author for correspondence: M. Türe, MD, Pediatric Cardiologist, Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey. Tel: +90 412 2488001. E-mail: drture21@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death.

Aim:

The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death.

Methods:

Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared.

Results:

The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 ± 1.76 years, and the haemoglobin A1c levels were 9.63% ± 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data.

Conclusion:

We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.

Keywords

Type 1 diabetes mellituselectrocardiographyarrhythmiasudden death
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 1 , January 2022 , pp. 106 - 110
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nathan, DM, Genuth, S, Lachin, J, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.Google ScholarPubMed
Atkinson, MA, Eisenbarth, GS, Michels, AW. Type 1 diabetes. Lancet 2014; 383: 69–82.CrossRefGoogle ScholarPubMed
Pulungan, AB, Afifa, IT, Annisa, D. Type 2 diabetes mellitus in children and adolescent: an Indonesian perspective. Ann Pediatr Endocrinol Metab 2018; 23: 119–125.CrossRefGoogle Scholar
Laing, SP, Swerdlow, AJ, Slater, SD, et al. The British Diabetic Association Cohort Study, II: cause-specific mortality in patients with insulin-treated diabetes mellitus. Diabet Med 1999; 16: 466–471.CrossRefGoogle ScholarPubMed
Orchard, TJ. From diagnosis, classification to complications, therapy. DCCT. Part II? Diabetes control and complications trial. Diabetes Care 1994; 17: 326–338.CrossRefGoogle ScholarPubMed
Nathan, DM, Cleary, PA, Backlund, JY, et al. Diabetes Control and Complications Trial/epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005; 353: 2643–2653.Google Scholar
Prince, CT, Becker, DJ, Costacou, T, Miller, RG, Orchard, TJ. Changes in glycaemic control and risk of coronary artery disease in type 1 diabetes mellitus: findings from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC). Diabetologia 2007; 50: 2280–2288.CrossRefGoogle Scholar
Vasiliadis, I, Kolovou, G, Mavrogeni, S, Nair, DR, Mikhailidis, DP. Sudden cardiac death and diabetes mellitus. J Diabetes Complications 2014; 28: 573–579.CrossRefGoogle ScholarPubMed
Weston, PJ. The dead in bed syndrome revisited: a review of the evidence. Diabetes Manag 2012; 2: 233–241.CrossRefGoogle Scholar
Cox, AJ, AzeemA, Yeboah, etal, J. Heart rate-corrected QT interval is an independent predictor of all-cause and cardiovascular mortality in individuals with type 2 diabetes: the diabetes heart study. Diabetes Care 2014; 37: 1454–1461.CrossRefGoogle ScholarPubMed
Mandala, S, Di, TC. ECG parameters for malignant ventricular arrhythmias: a comprehensive review. J Med Biol Eng 2017; 37: 441–453.CrossRefGoogle ScholarPubMed
Piers, SR, Everaerts, K, Van der Geest, RJ, et al. Myocardial scar predicts monomorphic ventricular tachycardia but not polymorphic ventricular tachycardia or ventricular fibrillation in nonischemic dilated cardiomyopathy. Heart Rhythm 2015; 12: 2106–2114.CrossRefGoogle ScholarPubMed
O’Neil, BJ, Hoekstra, J, Pride, YB, et al. Incremental benefit of 80-lead electrocardiogram body surface mapping over the 12-lead electrocardiogram in the detection of acute coronary syndromes in patients without ST-elevation myocardial infarction: results from the Optimal Cardiovascular Diagnostic Evaluation Enabling Faster Treatment of Myocardial Infarction (OCCULT MI) trial. Acad Emerg Med 2010; 17: 932–939.CrossRefGoogle ScholarPubMed
Montanez, A, Ruskin, JN, Hebert, PR, Lamas, GA, Hennekens, CH. Prolonged QTc interval and risks of total and cardiovascular mortality and sudden death in the general population: a review and qualitative overview of the prospective cohort studies. Arc Intern Med 2004; 164: 943–948.10.1001/archinte.164.9.943CrossRefGoogle ScholarPubMed
Vrtovec, B, Delgado, R, Zewail, A, et al. Prolonged QTc interval and high B-type natriuretic peptide levels together predict mortality in patients with advanced heart failure. Circulation 2003; 107: 1764–1769.10.1161/01.CIR.0000057980.84624.95CrossRefGoogle ScholarPubMed
Cox, A, Azeem, A, Yeboah, J, et al. Heart rate-corrected qt interval is an independent predictor of all-cause and cardiovascular mortality in individuals with type 2 diabetes: the diabetes heart study. Diabetes Care 2014; 37: 1454–1461.CrossRefGoogle ScholarPubMed
Okin, PM, Devereux, RB, Howard, BV, Fabsitz, RR, Lee, ET, Welty, TK. Assessment of QT interval and QT dispersion for prediction of all-cause and cardiovascular mortality in American Indians: the strong heart study. Circulation 2000; 101: 61–66.CrossRefGoogle ScholarPubMed
Rossing, P, Breum, L, Major-Pedersen, A, et al. Prolonged QTc interval predicts mortality in patients with type 1 diabetes mellitus. Diabet Med 2001; 18: 199–205.CrossRefGoogle ScholarPubMed
Giunti, S, Bruno, G, Lillaz, E, et al. Incidence and risk factors of prolonged QTc interval in type 1 diabetes: the EURODIAB Prospective Complications Study. Diabetes Care 2007; 30: 2057–2063.CrossRefGoogle ScholarPubMed
Piccirillo, G, Magri, D, Matera, S, et al. QT variability strongly predicts sudden cardiac death in asymptomatic subjects with mild or moderate left ventricular systolic dysfunction: a prospective study. Eur Heart J 2007; 28: 1344–1350.CrossRefGoogle ScholarPubMed
Tokatli, A, Kilicaslan, F, Alis, M, Yiginer, O, Uzun, M. Prolonged Tp-e interval, Tp- e/QT ratio and Tp-e/QTc ratio in patients with type 2 diabetes mellitus. Endocrinol Metab 2016; 31: 105–112.CrossRefGoogle Scholar
Uysal, F, Ozboyaci, E, Bostan, O, Saglam, H, Semizel, E, Cil, E. Evaluation of electrocardiographic parameters for early diagnosis of autonomic dysfunction in children and adolescents with type-1 diabetes mellitus. Pediatr Int 2014; 56: 675–680.CrossRefGoogle ScholarPubMed
Spodick, DH. Reduction of QT-interval imprecision and variance by measuring the JT interval. Am J Cardiol 1992; 70: 103.CrossRefGoogle ScholarPubMed
Alizade, E, Avcı, A, Fidan, S, et al. The effect of chronic anabolic-androgenic steroid use on Tp-E interval, Tp-E/Qt ratio, and Tp-E/Qtc ratio in male bodybuilders. Ann Noninvasive Electrocardiol 2015; 20: 592–600.CrossRefGoogle ScholarPubMed
Antzelevitch, C, Oliva, A. Amplification of spatial dispersion of repolarization underlies sudden cardiac death associated with catecholaminergic polymorphic VT, long QT, short QT and Brugada syndromes. J Intern Med 2006; 259: 48–58.CrossRefGoogle ScholarPubMed
Castro Hevia, J, Antzelevitch, C, Tornés Bárzaga, F, et al. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol 2006; 47: 1828–1834.CrossRefGoogle ScholarPubMed
Kors, JA, Ritsema van Eck, HJ, van Herpen, G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008; 41: 575–580.CrossRefGoogle ScholarPubMed
Erikssen, G, Liestøl, K, Gullestad, L, Haugaa, KH, Bendz, B, Amlie, JP. The terminal part of the QT interval (T peak to T end): a predictor of mortality after acute myocardial infarction. Ann Noninvasive Electrocardiol 2012; 17: 85–94.CrossRefGoogle Scholar
Inanır, M, Gunes, Y, Sincer, I, Erdal, E. Evaluation of electrocardiographic ventricular depolarization and repolarization variables in type 1 diabetes mellitus. Arq Bras Cardiol 2020; 114: 275–280.Google ScholarPubMed