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당뇨병성 심혈관계 자율신경병증 환자에서 Corrected QT 간격 연장에 관한 연구
박종선(Jong Seon Park),이찬우(Chan Woo Lee),전준하(Jun Ha Jeun),정성복(Seong Pok Cheong),원규장(Kyu Chag Won),이충기(Choong Ki Lee),현명수(Myung Soo Hyun),최수봉(Soo Bong Choi),이현우(Hyun Woo Lee),이인규(In Kyu Lee) 대한내과학회 1992 대한내과학회지 Vol.43 No.1
N/A Background: Diabetic cardiac autonomic neuropathy may result in sympathetic imbalance and QTc interval prolongation, predisposing these patients to arrhythmias and sudden death. A simple method for evaluating alterations in cardiac sympathetic innervation may be measurement of the QTc interval. We investigated the relations between QTc interval and diabetic cardiac autonomic neuropathy. Methods: Fifty five patients with type-II diabetics were separated into 4 groups based on the presence and degree of cardiac autonomic neuropathy (CAN) with noninvasive cardiovascular autonomic reflexes and blood pressure response. None of the patients had evidence of ischemic heart disease, or the idiopathic long QT interval syndrome. The corrected QT interval (QTc) was determined at rest with Bazett`s formula. Results: Diabetic patients with ³ 1 abnormality had a prolonged QTc interval compared with a control group of 55 healthy non-diabetic subjects (mean±SD 401±2msec) (p<0.001) and diabetic patients with ³2 abnormalities of cardiac autonomic function had a longer QTc interval than those with no evidence of CAN. There was a direct linear relationship between the severity of CAN and the QTc interval (r=0.559, p<0. 001), and the frequency of prolonged (>434msec, normal mean+2SD) resting QTc interval increased with the increasing number of abnormalities (CAN score 0, 1, 2, ³3:0%, 8%, 54%, and 63%), respectively. 15 patients had a prolonged QTe interval (mean 447msec) and 40 patients had a normal QTc interval (mean 414msec). The two groups were comparable in age (56 vs. 58yrs), and duration of diabetes (9 vs. 8yrs) and not comparable in degree of glycemic control (HbA1c 11.6 vs. 14.3%). All of 15 patients with a prolonged QTc interval had evidence of CAN. However, 32% (15 of 47) of patients with CAN had a prolonged QTc interval. Conclusion: These results suggest that the resting QTc interval may be an additional, noninvasive diagnostic tool in the assessment of CAN in patients with diabetes mellitus.
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