ASSOCIATION of QT INTERVAL INDICES WITH CARDIAC AUTONOMIC NEUROPATHY IN DIABETIC PATIENTS

Abstract

Relevance. Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as high as 90% of diabetic patients. Clinical manifestations range from orthostasis to myocardial infarction. The diagnosis is made using multiple autonomic function tests to assess both sympathetic and parasympathetic function.  Objective: this study was conducted to assess the relationship between Cardiac autonomic neuropathy and QT interval. Methods.  Cross sectional study was conducted in 100 patients attending tertiary care hospital. Deep breathing test, Valsalva ratio, immediate heart rate response to standing 30:15, B.P rise with sustained hand grip and postural hypotension. Scoring was done for cardiac autonomic neuropathy. QT interval and QTc interval were determined and association with CAN was obtained. Results. Out of 100 type-2 diabetic patients, 60% were males and 40% females. 25 patients having no cardiac autonomic neuropathy and had no prolonged QTc interval. While, 75 patients had QTc prolonged were associated with early and severe CAN cardiac autonomic neuropathy. The prolonged QTc was significantly associated with CAN in diabetic patients when compared without-CAN and controls (P<0001). Conclusion. Diabetic cardiac autonomic neuropathy is associated with increase in prolongation of QTc intervals. Hence there is need for regular checkup of autonomic nervous system in diabetic patient to prevent further complications.