Correlation of QT interval and heart rate variability in type 2 diabetic patients: Possible evidence for autonomic regulation of QT interval
2019
Objective: QT interval length in Electrocardiogram (ECG) has prognostic impact on the patients
with diabetes. This interval is influenced by autonomic nervous function, which is, however,
impaired in diabetic patients. Since exact mechanisms of autonomic regulation of QT interval
in diabetics remains unclear, this study aimed to investigate the relationship between heartrate-
corrected QT interval (QTc interval) and Heart Rate Variability (HRV) in diabetic patients.
Methods: Coefficient of variance of R-R intervals (CVRR:%) in digital ECG, as a representative
time-domain measure of HRV, was estimated immediately after recording 12-lead ECG in
type 2 diabetic (n=60) and nondiabetic control (n=62) groups. QTc interval was obtained
by Bazettâs formula where QTc=QT/RR1/2. Demographic and laboratory data were extracted
from medical records. Significant contributors of multiple clinical factors to the QTc interval
length were analyzed by multivariate analysis. Results: Body mass index (p<0.001) and CVRR
(p=0.015) contributed significantly to the QTc interval regulation in diabetic group, whereas
CVRR (p=0.037) alone contributed significantly to this interval in controls. However, CVRR was
correlated with the QTc interval negatively in diabetic group (standardized I²=-0.306), whereas
the opposite was found in the case of control group (standardized I²=0.266). Conclusion:
Although this allows a cross-sectional case-control study design, positive correlation of BMI
and QTc interval in diabetic patients indicates cardiometabolic linkage (r=0.339, p=0.008).
CVRR was considered to regulate QTc intervals. However, the details of this autonomic
regulation in diabetics differed from those in controls. The mechanisms of autonomic QTc
regulation in diabetics require future investigation.
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