FORECASTING THE RISK OF CARDIOVASCULAR COMPLICATIONS BASED ON CLUSTER ANALYSIS OF QT INTERVAL IN CHILDREN WITH TYPE 1 DIABETES
Abstract
Clinical and scientific experience of curation and analysis of children with type 1 diabetes and with acquired or congenital long QT syndrome (LQTS) health is not enough discovered for full control, treatment and risks prediction. Іn this work we investigated interconnection of type 1 diabetes in children and possibility of cardiovascular disorders taking into account the results of twenty-four-hour Holter ECG monitoring and measurement of QT and QTc in 3 leads (CM5, CS1, CS3) . To predict the risk of cardiovascular complications in the form of sudden ventricular life-threatening tachyarrhythmias, we made an assessment of risk groups using hierarchical cluster analysis and determined three groups. The low-risk group included children who did not have an increase in the duration of QT and QTc intervals in any of the leads; the high-risk group included children who had an increase in the duration of the QT and QTc intervals and the variance of these intervals in several leads simultaneously. The medium-risk group included children who had prolongation of QT and QTc intervals in only 1 lead or had a change in the variance of these intervals. According to the results of our analysis, the main goal of reducing the risk of life-threatening complications in children with type 1 diabetes is the timely diagnosis of long QT interval syndrome, especially its congenital form, for further management of these patients at simultaneous appointment of insulin therapy and correction of episodes of hypoglycemia, which can impair a course of a syndrome of the prolonged QT interval.
References
Andersen, A., Jørgensen, P. G., Knop, F. K., & Vilsbøll, T. (2020). Hypoglycaemia and cardiac arrhythmias in diabetes. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820911803. https://doi.org/10.1177/2042018820911803
Bilici, M., Fidancı-Dedeoğlu, Z., Demir, F., Akın, A., Türe, M., Balık, H., Tan, İ., & Ertuğrul, S. (2019). Prolonged QT dispersion is associated with pediatric syncope. The Turkish Journal of Pediatrics, 61, 85. https://doi.org/10.24953/turkjped.2019.01.013
Galli-Tsinopoulou, A., Chatzidimitriou, A., Kyrgios, I., Rousso, I., Varlamis, G., & Karavanaki, K. (2014). Children and adolescents with type 1 diabetes mellitus have a sixfold greater risk for prolonged QTc interval. Journal of Pediatric Endocrinology & Metabolism: JPEM, 27(3–4), 237–243. https://doi.org/10.1515/jpem-2013-0193
Hannoodi, F., Alwash, H., Shah, K., Ali, I., Kumar, S., & Zakaria, K. (2017). A Case of Hypoglycemiainduced QT Prolongation Leading to Torsade de Pointes and a Review of Pathophysiological Mechanisms. Clinics and Practice, 7(3). https://doi.org/10.4081/cp.2017.960
Makarov L.M. (2017). Kholterovskoe monitorirovaniye [Holter monitoring] ( 4-th ed). M:Medpraktika-M [in Russian].
Mozos, I. (2014). Ventricular Arrhythmia Risk in Noncardiac Diseases. Cardiac Arrhythmias - Mechanisms, Pathophysiology, and Treatment. https://doi.org/10/ghpcx3
Nakashima, T., Kubota, T., Takasugi, N., Kitagawa, Y., Yoshida, T., Ushikoshi, H., Kawasaki, M., Nishigaki, K., Ogura, S., & Minatoguchi, S. (2017). Hyperglycemia and subsequent torsades de pointes with marked QT prolongation during refeeding. Nutrition (Burbank, Los Angeles County, Calif.), 33, 145–148. https://doi.org/10.1016/j.nut.2016.05.012
O’Hare, M., Maldonado, Y., Munro, J., Ackerman, M. J., Ramakrishna, H., & Sorajja, D. (2018). Perioperative management of patients with congenital or acquired disorders of the QT interval. British Journal of Anaesthesia, 120(4), 629–644. https://doi.org/10.1016/j.bja.2017.12.040
Rautaharju Pentti M., Surawicz Borys, & Gettes Leonard S. (2009). AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Circulation, 119(10), e241–e250. https://doi.org/10.1161/CIRCULATIONAHA.108.191096
Secrest, A. M., Becker, D. J., Kelsey, S. F., LaPorte, R. E., & Orchard, T. J. (2011). Characterising sudden death and dead-in-bed syndrome in Type 1 diabetes: Analysis from 2 childhood-onset Type 1 diabetes registries. Diabetic Medicine : A Journal of the British Diabetic Association, 28(3), 293–300. https://doi.org/10/fwgrxr
Skinner, J. R., Marquis-Nicholson, R., Luangpraseuth, A., Cutfield, R., Crawford, J., & Love, D. R. (2014, February 19). Diabetic Dead-in-Bed Syndrome: A Possible Link to a Cardiac Ion Channelopathy [Case Report]. Case Reports in Medicine; Hindawi. https://doi.org/10.1155/2014/647252
Steinberg, J. S., Varma, N., Cygankiewicz, I., Aziz, P., Balsam, P., Baranchuk, A., Cantillon, D. J., Dilaveris, P., Dubner, S. J., El-Sherif, N., Krol, J., Kurpesa, M., Rovere, M. T. L., Lobodzinski, S. S., Locati, E. T., Mittal, S., Olshansky, B., Piotrowicz, E., Saxon, L., … Piotrowicz, R. (2017). 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry. Heart Rhythm, 14(7), e55–e96. https://doi.org/10/gbpd8h
Tan, H. L., van Dongen, L. H., & Zimmerman, D. S. (2020). Sudden cardiac death in young patients with diabetes: A call to study additional causes beyond ischaemic heart disease. European Heart Journal, 41(28), 2707–2709. https://doi.org/10/ghk2kp
Weston, P. J. (2012). The dead in bed syndrome revisited: A review of the evidence. Diabetes Management, 2(3), 233–241. https://doi.org/10.2217/dmt.12.2
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