Research Article
Year 2021,
Volume: 43 Issue: 1, 49 - 54, 31.03.2021
Abstract
References
- Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50. doi: 10.1016/j.diabres.2017.03.024
- Scheen AJ. Cardiovascular Effects of New Oral Glucose-Lowering Agents: DPP-4 and SGLT-2 Inhibitors. Circ Res. 2018 May 11;122(10):1439-1459. doi: 10.1161/CIRCRESAHA.117.311588
- Pham SV, Chilton RJ. EMPA-REG OUTCOME: The Cardiologist's Point of View. Am J Cardiol. 2017 Jul 1;120(1S):S53-S58. DOI: 10.1016/j.amjcard.2017.05.011
- Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008;41:567-74. doi: 10.1016/j.jelectrocard.2008.07.016
- Ardahanli I, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22. doi: 10.5455/annalsmedres.2020.09.949
- Tokatli A, Kiliçaslan F, Alis M, et al. Prolonged Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with type 2 diabetes mellitus. Endocrinol Metab (Seoul) 2016;31:105-12. doi: 10.3803/EnM.2016.31.1.105
- Akhan O, Ardahanlı İ. Evaluation of Ventricular Polarization in Noncompaction Cardiomyopathy with Electrocardiography in a Different Perspective. ECM 2020;8(4):180-185. doi: 10.32596/ejcm.galenos.2020.08.044
- Braschi A, Frasheri A, Lombardo RM, et al. Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiol. 2020 Jun 12:1-7. doi: 10.1080/00015385.2020.1776012
- Ardahanli I, Akyuz O. The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selcuk Med J 2021;10.30733/std.2021.01491
- Zelniker TA, Bonaca MP, Furtado RHM, Mosenzon O, Kuder JF, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Budaj A, Kiss RG, Padilla F, Gause-Nilsson I, Langkilde AM, Raz I, Sabatine MS, Wiviott SD. Effect of Dapagliflozin on Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus: Insights From the DECLARE-TIMI 58 Trial. Circulation. 2020 Apr 14;141(15):1227-1234. DOI: 10.1161/CIRCULATIONAHA.119.044183
- Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008; 41:575-80. doi: 10.1016/j.jelectrocard.2008.07.030
- Kusaka H, Koibuchi N, Hasegawa Y, Ogawa H, Kim-Mitsuyama S. Empagliflozin lessened cardiac injury and reduced visceral adipocyte hypertrophy in prediabetic rats with metabolic syndrome. Cardiovasc Diabetol. 2016 Nov 11;15(1):157. DOI: 10.1186/s12933-016-0473-7
- Hashikata T, Ikutomi M, Jimba T, Shindo A, Kakuda N, Katsushika S, Yokoyama M, Kishi M, Sato T, Matsushita M, Ohnishi S, Yamasaki M. Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes. Heart Vessels 2020; 35(10) :1378-89. doi:10.1007/s00380-020-01621-0
- Durak A, Olgar Y, Degirmenci S, Akkus E, Tuncay E, Turan B. A SGLT2 inhibitor dapagliflozin suppresses prolonged ventricular-repolarization through augmentation of mitochondrial function in insulin-resistant metabolic syndrome rats. Cardiovasc Diabetol. 2018 Nov 17;17(1):144. DOI: 10.1186/s12933-018-0790-0
Year 2021,
Volume: 43 Issue: 1, 49 - 54, 31.03.2021
Abstract
Objective: Tp-e, QT, and Tp-e / QT are parameters showing ventricular repolarization. The increase in these parameters causes an increase in cardiovascular mortality, mostly due to malignant arrhythmias. Our study aimed to compare the long-term changes in electrocardiographic parameters in patients with uncontrolled diabetes despite using metformin, with the addition of SGLT 2 inhibitor or sulfonylurea (SU) to the treatment.
Method: This retrospective study was enrolled in 133 type 2 DM patients with uncontrolled diabetes who applied to the internal medicine outpatient clinic, using single oral antidiabetic agents. The patients were divided into two groups as SU and SGLT 2 inhibitor additive. SU was added to the treatment of 69 patients, and SGLT 2 inhibitor was added to 64 patients. 12-lead superficial ECG records of participants who received combined therapy for at least six months were analyzed and compared. RR distance, QT interval, and Tp-e intervals were measured on the ECG. QTc was calculated using Bazzet's formula. (QT/ √ RR). Tp-e / QT and Tp-e / QTc ratios were calculated.
Results: Seventy-eight (58.6%) of the participants were female, and 55 (41.4) were male. The age and gender distribution of both groups were similar. The group to which SGLT 2 inhibitor was added, Tp-e, QT, and QTc distances were significantly lower than the SU group (p <0.001 for each). Also, the Tp-e / QT and Tp-e / QTc ratios were significantly greater in the SU group (0.210 ± 0.029 vs 0.190 ± 0.03; p <0.001 and 0.201 ± 0.051 vs 0.184 ± 0.032; p = 0.022 respectively).
Conclusions: In our study, we showed that the addition of SGLT2 inhibitors to monotherapy in people with diabetes with poor glycemic control has a positive effect on ECG parameters, which are indicators of repolarization, compared to other oral antidiabetics.
References
- Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50. doi: 10.1016/j.diabres.2017.03.024
- Scheen AJ. Cardiovascular Effects of New Oral Glucose-Lowering Agents: DPP-4 and SGLT-2 Inhibitors. Circ Res. 2018 May 11;122(10):1439-1459. doi: 10.1161/CIRCRESAHA.117.311588
- Pham SV, Chilton RJ. EMPA-REG OUTCOME: The Cardiologist's Point of View. Am J Cardiol. 2017 Jul 1;120(1S):S53-S58. DOI: 10.1016/j.amjcard.2017.05.011
- Gupta P, Patel C, Patel H, et al. T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008;41:567-74. doi: 10.1016/j.jelectrocard.2008.07.016
- Ardahanli I, Celik M. Comparison of Tp-e interval, QTc interval and Tp-e/QTc ratios between non-diabetic and prediabetic population. Ann Med Res 2020;27(12):3117-22. doi: 10.5455/annalsmedres.2020.09.949
- Tokatli A, Kiliçaslan F, Alis M, et al. Prolonged Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with type 2 diabetes mellitus. Endocrinol Metab (Seoul) 2016;31:105-12. doi: 10.3803/EnM.2016.31.1.105
- Akhan O, Ardahanlı İ. Evaluation of Ventricular Polarization in Noncompaction Cardiomyopathy with Electrocardiography in a Different Perspective. ECM 2020;8(4):180-185. doi: 10.32596/ejcm.galenos.2020.08.044
- Braschi A, Frasheri A, Lombardo RM, et al. Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome. Acta Cardiol. 2020 Jun 12:1-7. doi: 10.1080/00015385.2020.1776012
- Ardahanli I, Akyuz O. The Effect of Hemodialysis Treatment on Ventricular Arrhythmogenesis Parameters in Electrocardiography. Selcuk Med J 2021;10.30733/std.2021.01491
- Zelniker TA, Bonaca MP, Furtado RHM, Mosenzon O, Kuder JF, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Budaj A, Kiss RG, Padilla F, Gause-Nilsson I, Langkilde AM, Raz I, Sabatine MS, Wiviott SD. Effect of Dapagliflozin on Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus: Insights From the DECLARE-TIMI 58 Trial. Circulation. 2020 Apr 14;141(15):1227-1234. DOI: 10.1161/CIRCULATIONAHA.119.044183
- Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008; 41:575-80. doi: 10.1016/j.jelectrocard.2008.07.030
- Kusaka H, Koibuchi N, Hasegawa Y, Ogawa H, Kim-Mitsuyama S. Empagliflozin lessened cardiac injury and reduced visceral adipocyte hypertrophy in prediabetic rats with metabolic syndrome. Cardiovasc Diabetol. 2016 Nov 11;15(1):157. DOI: 10.1186/s12933-016-0473-7
- Hashikata T, Ikutomi M, Jimba T, Shindo A, Kakuda N, Katsushika S, Yokoyama M, Kishi M, Sato T, Matsushita M, Ohnishi S, Yamasaki M. Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes. Heart Vessels 2020; 35(10) :1378-89. doi:10.1007/s00380-020-01621-0
- Durak A, Olgar Y, Degirmenci S, Akkus E, Tuncay E, Turan B. A SGLT2 inhibitor dapagliflozin suppresses prolonged ventricular-repolarization through augmentation of mitochondrial function in insulin-resistant metabolic syndrome rats. Cardiovasc Diabetol. 2018 Nov 17;17(1):144. DOI: 10.1186/s12933-018-0790-0
There are 14 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | March 31, 2021 |
| Acceptance Date | March 28, 2021 |
| Published in Issue | Year 2021Volume: 43 Issue: 1 |