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당뇨병 환자에서 자율신경병증과 교정한 QT 간격과의 관계
조정구(Chung Gu Cho),임동석(Dong Suk Lim),최석채(Suk Chae Choi),홍석욱(Seung Wook Hong),장근(Geun Jang),김동훈(Dong Hun Kim),김창일(Chang Il Kim),박옥규(Ock Kyu Park) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A A simple method for evaluating alterations in cardiac sympathetic innervation may be measurement of the QT interval. Ninety-nine diabetic patients were separated into 4 groups based on the presence and degree of cardiac autonomic neuropathy (CAN) with noninvasive cardiovascular reflexes and blood pressure responses. None of the patients had evidence of ischemic heart disease, arrhythmia, or electrolyte imbalance. The corrected QT interval (QTc) was determined at rest with Bazett's formula. As a group, diabetic patients with 4 abnormalities of cardiac autonomic function had a longer QTc interval than those with no evidence of CAN. Diabetic patients with > 1 abnormality had a prolonged QTc interval compared with the control group of 68 healthy nondiabetic subjects. The frequency of prolonged (>430 ms, normal+2SD) resting QTc intervals increased with the increased number of abnormalities (0, 1-3, ?4): 19, 33, and 49%, respectively, Thirty out of 35 (86%) patients with a QTc >430ms had evidence of CAN. However, 59% (43 out of 73) of the patients with CAN had a normal QTc interval. These data provide evidence of a relationship between the presence and severity of CAN and degree of QTc interval prolongation. Compared with cardiovascular reflexes and blood pressure tests for CAN, the QTc interval in the group of diabetic patients studied without evidence of heart or electrolyte imbalance was an insensitive but specific marker. An abnormal QTc interval may be an additional diagnostic tool for evaluating CAN in patients with diabetes mellitus.