The arrhytmias in patients with diabetes mellitus

Czech version

Authors: M. Migra; F. Kovář; M. Mokáň
Authors‘ workplace: I. interná klinika Jesseniovej lekárskej fakulty UK a UN Martin, Slovenská republika, prednosta prof. MU Dr. Marián Mokáň, DrSc., FRCP Edin.
Published in: Vnitř Lék 2013; 59(5): 361-365
Category: Review

Overview

Cardiovascular disorders are the most common reason of morbidity and mortality worldwide. The prevalence of diabetes mellitus, which is strongly associated with cardiac and cerebrovascular events, is increasing during the last decades. Based on the results of clinical studies we summarize in the review article the risk factors and patomechanisms connecting diabetes mellitus to incidence of arrhythmias and sudden cardiac death. The paper analyzes influence of diabetes mellitus on atrial fibrillation and arrhythmogenic effect of antidiabetic drugs.

Key words:
diabetes mellitus – arrhythmias – sudden cardiac death

Sources

1. Benjamin EJ, Levy D, Vaziri SM et al. Independent risk factors for atrial fibrillation in a population‑based cohort. The Framingham Heart Study. JAMA 1994; 271: 840– 844.

2. Rácz O, Šikulová A. Patogenéza chronických komplikácií. In: Kreze A, Langer P, Klimeš I et al. Všeobecná a klinická endokrinológia. Bratislava: Academic Electronic Press 2004; 653– 656.

3. Kim SH, Park KW, Kim YS et al. Effects of acute hyperglycemia on endothelium‑ dependent vasodilation in patients with diabetes mellitus or impaired glucose metabolism. Endothelium 2003; 2: 65– 70.

4. Libby P, Bonow RO, Zipes DP et al. Braunwald‘s Heart Disease e‑ dition, 8th Edition. Saunders. 2008; 2288 s.

5. Nakou ES, Mavrakis H, Vardas PE. Are diabetic patients at increased risk of arrhythmias? Hellenic J Cardiol 2012; 53: 335– 339.

6. Lacigová S. The heart of a patient with type 1 diabetes. Vnitř Lék 2010; 56: 418.

7. Mokáň M, Migra M, Kutlák M et al. 99mTc – Myoview gated – SPET and heart rate variability measurement in detection of early cardiovascular changes in diabetic patients. Diabetologia 2010; 53: (Suppl. 1): S454.

8. Javorka M, Javorkova J, Tonhajzerova I et al. Parasympathetic versus sympathetic control of the cardiovascular system in young patients with type 1 diabetes mellitus. Clin Physiol Funct Imaging 2005; 25: 270– 274.

9. Priori SG, Aliot E, Blomstrom‑ Lundqvist C et al. Update of the guidelines on sudden cardiac death of the European Society of Cardiology. Eur Heart J 2003; 24: 13– 15.

10. Skrapari I, Tentolouris N, Katsilambros N. Baroreflex function: determinants in healthy subjects and disturbances in diabetes, obesity and metabolic syndrome. Curr Diabetes Rev 2006; 2: 329– 338.

11. Singh JP, Larson MG, O’Donnell CJ et al. Association of hyperglycemia with reduced heart rate variability (The Framingham Heart Study). Am J Cardiol 2000; 86: 309– 312.

12. Kopaleishvili A, Akhobadze T, Kurashvili R et al. Complex ventricular arrhythmias with early repolarization in type 2 diabetes mellitus. Endocrine Abstracts 2012; 29: P621.

13. Go AS, Hylek EM, Phillips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370– 2375.

14. Rutter MK, Parise H, Benjamin EJ et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex‑related differences in the Framingham Heart Study. Circulation 2003; 107: 448– 454.

15. Sun Y, Hu D. The link between diabetes and atrial fibrillation: cause or correlation? J Cardiovasc Dis Res 2010; 1: 10– 11.

16. Velagaleti RS, Massaro J, Vasan RS et al. Relations of lipid concentrations to heart failure incidence: the Framingham Heart Study. Circulation 2009; 120: 2345– 2351.

17. Chung MK, Martin DO, Sprecher D et al. C‑ reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104: 2886– 2889.

18. Olgin JE, Sih HJ, Hanish S et al. Heterogeneous atrial denervation creates substrate for sustained atrial fibrillation. Circulation 1998; 98: 2608– 2614.

19. Schmid H, Forman LA, Cao X et al. Heterogeneous cardiac sympathetic denervation and decreased myocardial nerve growth factor in streptozotocin‑induced diabetic rats: implications for cardiac sympathetic dysinnervation complicating diabetes. Diabetes 1999; 48: 603– 608.

20. Stratmann B, Tschöpe D. Atrial fibrillation and diabetes mellitus. Correlation, co‑ existence, and coagulation therapy. Herz 2012; 37: 258– 263.

21. Krahn AD, Manfreda J, Tate RB et al. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow‑Up Study. Am J Med 1995; 98: 476– 484.

22. Aksnes TA, Schmieder RE, Kjeldsen SE et al. Impact of new‑onset diabetes mellitus on development of atrial fibrillation and heart failure in high‑risk hypertension (from the VALUE Trial). Am J Cardiol 2008; 101: 634– 638.

23. Haywood LJ, Ford CE, Crow RS et al. ALLHAT Collaborative Research Group. Atrial fibrillation at baseline and during follow‑up in ALLHAT (Antihypertensive and Lipid‑ Lowering Treatment to Prevent Heart Attack Trial). J Am Coll Cardiol 2009; 54: 2023– 2031.

24. Du X, Ninomiya T, de Galan B et al. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study. Eur Heart J 2009; 30: 1128– 1135.

25. Camm AJ, Lip GY, De Caterina R et al. Focused update of the ESC Guidelines for the management of atrial fibrillation: An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2012; Aug 24 (Epub ahead of print).

26. Zheng ZJ, Croft JB, Giles WH et al. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001; 104: 2158– 2163.

27. Kucharska‑ Newton AM, Couper DJ, Pankow JS et al. Diabetes and the risk of sudden cardiac death, the Atherosclerosis Risk in Communities study. Acta Diabetol 2010; 47: (Suppl. 1): 161– 168.

28. Yeung CY, Lam KS, Li SW et al. Sudden cardiac death after myocardial infarction in type 2 diabetic patients with no residual myocardial ischemia. Diabetes Care http:/ / www.ncbi.nlm.nih.gov/ pubmed?term=yeung%20CY%2C%20Lam%20KS%202012 2012; 35: 2564– 1569.

29. Pankow JS, Kwan DK, Duncan BB et al. Cardiometabolic risk in impaired fasting glucose and impaired glucose tolerance: the Atherosclerosis Risk in Communities Study. Diabetes Care 2007; 30: 325– 331.

30. Jouven X, Lemaitre RN, Rea TD et al. Diabetes, glucose level, and risk of sudden cardiac death. Eur Heart J 2005; 26: 2142– 2147.

31. Siscovick DS, Sotoodehnia N, Rea TD et al. Type 2 diabetes mellitus and the risk of sudden cardiac arrest in the community. Rev Endocr Metab Disord 2010; 11: 53– 59.

32. Rydén L, Standl E, Bartnik M et al. Guidelines on diabetes, pre‑diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J 2007; 28: 88– 136.

33. Kannel WB, Cupples LA, De Agostino RB. Sudden death risk in overt coronary heart disease: the Framingham Study. Am Heart J 1987; 113: 799– 804.

34. Balkau B, Jouven X, Ducimetiere P et al. Diabetes as a risk factor for sudden death. Lancet 1999; 354: 1968– 1969.

35. Suhonen O, Reunanen A, Knekt P et al. Risk factors for sudden and non‑sudden coronary death. Acta Med Scand 1988; 223: 19– 25.

36. Wannamethee G, Shaper AG, Macfarlane PW et al. Risk factors for sudden cardiac death in middle‑ aged British men. Circulation 1995; 91: 1749– 1756.

37. Vaykshnorayte MA, Ovechkin AO, Azarov JE. The effect of diabetes mellitus on the ventricular epicardial activation and repolarization in mice. Physiol Res 2012; 61: 363– 370.

38. Tong NW, Yang TG, Liang JZ. Ventricular late potentials in patients with diabetes mellitus. Zhonghua Nei Ke Za Zhi 1993; 32: 464– 466.

39. Clemente D, Pereira T, Ribeiro S. Ventricular repolarization in diabetic patients: characterization and clinical implications. Arq Bras Cardiol 2012; 99: 1015– 1022.

40. Bacharova L, Krivosikova Z, Wsolova L et al. Alterations in the QRS complex in the offspring of patients with metabolic syndrome and diabetes mellitus: early evidence of cardiovascular pathology. J Electrocardiol 2012; 45: 244– 251.

41. Algra A, Tijssen JG, Roelandt JR et al. QT interval variables from 24 hour electrocardiography and the two year risk of sudden death. Br Heart J 1993; 70: 43– 48.

42. Campbell RW, Gardiner P, Amos PA et al. Measurement of the QT interval. Eur Heart J 1985; 6: 81– 83.

43. Giunti S, Gruden G, Fornengo P et al. Increased QT interval dispersion predicts 15‑year cardiovascular mortality in type 2 diabetic subjects: the population‑based Casale Monferrato Study. Diabetes Care 2012; 35: 581– 583.

44. Siscovick DS, Sotoodehnia N, Rea TD et al. Type 2 diabetes mellitus and the risk of sudden cardiac arrest in the community. Rev Endocr Metab Disord 2010; 11: 53– 59.

45. Hatala R, Kaliská G, Margitfalvi P et al. Odporúčania pre implantácie ICD v podmienkach klinickej praxe v Slovenskej Republike. Kardiológia pre prax 2007; 3: (Suppl. S1): 1– 7.

46. Goldman D. The electrocardiogram in insulin shock. Arch Intern Med 1940; 66: 93– 108.

47. Read RC, Doherty JE. Cardiovascular effects of induced insulin hypoglycemia in man during the Hollander test. Am J Surg 1970; 119: 155– 162.

48. Lindstrom T, Jorfeldt L, Tegler L et al. Hypoglycaemia and cardiac arrhythmias in patients with type 2 diabetes mellitus. Diabet Med 1992; 9: 536– 541.

49. Rokas S, Mavrikakis M, Iliopoulou A et al. Proarrhythmic effects of reactive hypoglycemia. PACE Pacing Clin Electrophysiol 1992; 15: 373– 376.

50. Odeh M, Oliven A, Bassan H. Transient atrial fibrillation precipitated by hypoglycemia. Ann Emerg Med 1990; 19: 565– 567.

51. Frier BM, Barr SG, Walker JD. Fatal cardiac arrest following acute hypoglycemia in a diabetic patient. Pract Diabetes Int 1995; 12: 284.

52. Fisher BM, Frier BM. Haemodynamic responses and functional changes in major organs. In: Frier BM, Fisher BM (eds.) Hypoglycemia and diabetes: Clinical and Physiological Aspects. Sevenoaks, UK: Edwards Arnold 1993; 144– 155.

53. Mokan M. Hypoglycaemia. Martin: P+M Martin 2005.

54. Landstedt‑ Hallin L, Englund A, Adamson U et al. Increased QT dispersion during hypoglycaemia in patients with type 2 diabetes mellitus. J Intern Med 1999; 246: 299– 307.

55. Gruden G, Giunti S, Barutta F et al. QTc interval prolongation is independently associated with severe hypoglycemic attacks in type 1 diabetes from the EURODIAB IDDM complications study. Diabetes Care 2012; 35: 125– 127.

56. Heller SR. Abnormalities of the electrocardiogram during hypoglycaemia: the cause of the dead in bed syndrome? Int J Clin Pract Suppl 2002; 129: 27– 32.

57. Cacciapuoti F, Spezia R, Bianchi U et al. Effectiveness of glibenclamide on myocardial ischemic ventricular arrhythmias in non‑insulin‑dependent diabetes mellitus. Am J Cardiol 1991; 67: 843– 847.

5. Rana JS, Mukamal KJ, Nesto RW et al. Effect of diabetes mellitus and its treatment on ventricular arrhythmias complicating acute myocardial infarction. Diabet Med 2005; 22: 576– 582.

59. Zinn A, Felson S, Fisher E et al. Reassessing the cardiovascular risks and benefits of thiazolidinediones. Clin Cardiol 2008; 31: 397– 403.

60. Lu L, Reiter MJ, Xu Y et al. Thiazolidinedione drugs block cardiac KATP channels and may increase propensity for ischaemic ventricular fibrillation in pigs. Diabetologia 2008; 51: 675– 685.

61. Palee S, Weerateerangkul P, Surinkeaw S et al. Effect of rosiglitazone on cardiac electrophysiology, infarct size and mitochondrial function in ischaemia and reperfusion of swine and rat heart. Exp Physiol 2011; 96: 778– 789.

62. Sarraf M, Lu L, Ye S et al. Thiazolidinedione drugs promote onset, alter characteristics, and increase mortality of ischemic ventricular fibrillation in pigs. Cardiovasc Drugs Ther 2012; 26: 195– 204.

63. Costa EC, Gonçalves AA, Areas MA et al. Effects of metformin on QT and QTc interval dispersion of diabetic rats. Arq Bras Cardiol 2008; 90: 232– 238.

64. Sonne DP, Engstrøm T, Treiman M. Protective effects of GLP‑1 analogues exendin‑4 and GLP‑1(9– 36) amide against ischemia‑ reperfusion injury in rat heart. Regul Pept 2008; 146: 243– 249.

65.Treiman M, Elvekjaer M, Engstrøm T et al. Glucagon‑like peptide 1– a cardiologic dimension. Trends Cardiovasc Med 2010; 20: 8– 12.

66. Sokos GG, Bolukoglu H, German J. Effect of glucagon‑like peptide‑ 1 (GLP‑1) on glycemic control and left ventricular function in patients undergoing coronary artery bypass grafting. Am J Cardiol 2007; 100: 824– 829.