Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus

• Published in: Annals of noninvasive electrocardiology Vol. 21; no. 1; pp. 69 - 81
• Main Authors: Chen, Jia, Lin, Yubi, Yu, Jian, Chen, Wanqun, Xu, Zhe, Yang, Zhenzhen, Zeng, Chuqian, Li, Wenfeng, Lai, Xiaoshu, Lu, Qiji, Zhou, Jingwen, Tian, Bixia, Xu, Jing, Lin, Yanping, Du, Zuoyi, Zhang, Aidong
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.01.2016; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Aged; Apoprotein(a) - blood; diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Cardiomyopathies - diagnosis; Diabetic Cardiomyopathies - physiopathology; electrocardiography monitoring; Electrocardiography, Ambulatory; Female; Humans; Lipid Metabolism; Male; Middle Aged; Original; planar vector; Random Allocation; Risk Factors; planar vector; diabetes mellitus; electrocardiography monitoring
• ISSN: 1082-720X; 1542-474X
• DOI: 10.1111/anec.12276

Aims Research related to type 2 diabetes mellitus (DM) and parameters of electrocardiography (ECG) was limited. Patients with and without DM (NDM) were randomly enrolled in a study to exploit the influence of DM on planar QRS and T vectors derived from the Virtual Holter process. Methods A total of 216 (NDM) and 127 DM patients were consecutively and randomly recruited. We selected a 1‐minute length of ECG, which was scheduled for analysis at 4 AM. After a series of calculating algorisms, we received the virtual planar vector parameters. Results Patients with DM were elderly (65.61 ± 12.08 vs 59.41 ± 16.86 years, P < 0.001); higher morbidity of hypertension (76.38% vs 58.14%, P < 0.001) and coronary artery disease (44.09% vs 32.41%, P = 0.03); thicker interventricular septum (10.92 ± 1.77 vs 10.08 ± 1.96 mm, P < 0.001) and left ventricular posterior wall (9.84 ± 1.38 vs 9.39 ± 1.66 mm, P = 0.03); higher lipid levels and average heart rate (66.67 ± 12.04 vs 61.87 ± 13.36 bpm, P < 0.01); higher angle of horizontal QRS vector (HQRSA, –2.87 ± 48.48 vs –19.00 ± 40.18 degrees, P < 0.01); lower maximal magnitude of horizontal T vector (HTV, 2.33 ± 1.47 vs 2.88 ± 1.89 mm, P = 0.01) and maximal magnitude of right side T vector (2.77 ± 1.55 vs 3.27 ± 1.92 mm, P = 0.03), and no difference in angle of frontal QRS‐T vector (FQRSTA, 32.77 ± 54.20 vs 28.39 ± 52.87 degrees, P = 0.74) compared with patients having NDM. After adjusting for confounding factors, DM was significantly effective on FQRSTA (regression coefficient –40.0, 95%CI –66.4 to –13.6, P < 0.01), HQRSA (regression coefficient 22.6, 95%CI 2.5 to 42.8, P = 0.03), and HTV (regression coefficient 0.9, 95%CI 0.2 to 1.7, P = 0.01). Confounding factors included: sex, 2‐hour postprandial blood glucose, smoking, triglyceride, apolipoprotein A, creatinine, left ventricular ejection fraction, and average heart rate. Conclusions The risk factors of DM and lipid metabolism abnormality particularly apolipoprotein A significantly modified parameters of virtual planar QRS and T vector, including frontal QRS‐T angle.