QTc Dispersion in Cardiac Autonomic Neuropathy and Its Correlation With Diastolic Dysfunction In Type 2 Diabetes: The Basis for Non Ischemic Diabetic Cardiomyopathy

Abstract

INTRODUCTION: Diabetic cardiac autonomic neuropathy is aserious complication with poor prognosis results in silent ischemia and left ventricle dysfunction. Increased QT dispersion is used as a marker of diabetic autonomic neuropathy .Sympathetic overactivity stimulates RAAS which has direct noxious effects on cardiomyocytes. AIM OF THE STUDY: The primary aim of this study is to observe the utility of prolongation of corrected (QTc) interval in the ECG to diagnose CAN in patients with diabetes mellitus and to study the prevalence of diastolic dysfunction –the basis for non ischemic cardiomyopathy?. Secondarily to study the prevalence and risk factors for cardiac autonomic neuropathy. MATERIALS AND METHODS: An observational study was conducted in our hospital among 100 type 2 diabetic patients of more than 5 yrs duration without any complications and 100 age and sex matched healthy individuals as controls .All undergone cardiac autonomic function tests using CAN analyser and were graded as normal mild and severe. QTd were calculated using bazets formula in 12 lead ecg. All were subjected to echo. Left ventricle diastolic dysfunction were graded as normal grade 1/2/3. Statistical analysis were done using SPSS software. RESULTS: QT d and CAN association are statistically significant. There is association between QTD and LVDD.Prevalence of CAN and LVDD is high. Age, duration obesity, duration of diabetes ,glycemic control all influences CAN. CONCLUSION: Prevalence of cardiac autonomic neuropathy and left ventricle diastolic dysfunction is high which produces serious morbidity and mortality .With using simple ecg and echo testing in type 2 diabetic patients of longer duration we can identify high risk group for sudden cardiac death in early stag