Cardiac repolarization during hypoglycaemia in type 1 diabetes: impact of basal renin-angiotensin system activity.
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Cardiac repolarization during hypoglycaemia in type 1 diabetes: impact of basal renin-angiotensin system activity. / Due-Andersen, Rikke; Høi-Hansen, Thomas; Larroude, Charlotte Ellen; Olsen, Niels Vidiendal; Kanters, Jørgen Kim; Boomsma, Frans; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger.
In: Europace, Vol. 10, No. 7, 2008, p. 860-7.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cardiac repolarization during hypoglycaemia in type 1 diabetes: impact of basal renin-angiotensin system activity.
AU - Due-Andersen, Rikke
AU - Høi-Hansen, Thomas
AU - Larroude, Charlotte Ellen
AU - Olsen, Niels Vidiendal
AU - Kanters, Jørgen Kim
AU - Boomsma, Frans
AU - Pedersen-Bjergaard, Ulrik
AU - Thorsteinsson, Birger
N1 - Keywords: Adult; Blood Glucose; Cross-Over Studies; Death, Sudden, Cardiac; Diabetes Mellitus, Type 1; Electrocardiography; Epinephrine; Female; Heart Rate; Humans; Hypoglycemia; Insulin; Male; Middle Aged; Prognosis; Renin-Angiotensin System; Risk Factors; Single-Blind Method; Tachycardia, Ventricular
PY - 2008
Y1 - 2008
N2 - AIMS: Hypoglycaemia-induced cardiac arrhythmias may be involved in the pathogenesis of the 'dead-in-bed syndrome' in patients with type 1 diabetes. Evidence suggests that the renin-angiotensin system (RAS) influences the occurrence of arrhythmias. The aim of this study was to explore if basal RAS activity affects cardiac repolarization during hypoglycaemia, thereby potentially carrying prognostic information on risk of the 'dead-in-bed syndrome'. METHODS AND RESULTS: Nine subjects with high RAS activity and nine subjects with low RAS activity were subjected to single-blinded placebo-controlled hypoglycaemia (nadir plasma glucose 2.4 mmol/L). QTc/QTcF and QT dynamics were registered by Holter monitoring. QTc prolonged during [8 (+/-2.3) ms, P < 0.01] and after [11 (+/-3) ms, P < 0.001] hypoglycaemia. Dynamic QT parameters reacted ambiguously. Low RAS activity was associated with a slightly more pronounced QT prolongation [6 (+/-3) ms, P = 0.04]. Adrenaline tended to increase more in the low-RAS group (P = 0.08) and was correlated to QTc (r = 0.67, P < 0.01) and QTcF (r = 0.58, P < 0.05) during hypoglycaemia. CONCLUSION: Low basal RAS activity may be associated with a slightly more pronounced QT prolongation during hypoglycaemia, when compared with high RAS activity. The impact, however, is modest and the clinical consequence is unclear.
AB - AIMS: Hypoglycaemia-induced cardiac arrhythmias may be involved in the pathogenesis of the 'dead-in-bed syndrome' in patients with type 1 diabetes. Evidence suggests that the renin-angiotensin system (RAS) influences the occurrence of arrhythmias. The aim of this study was to explore if basal RAS activity affects cardiac repolarization during hypoglycaemia, thereby potentially carrying prognostic information on risk of the 'dead-in-bed syndrome'. METHODS AND RESULTS: Nine subjects with high RAS activity and nine subjects with low RAS activity were subjected to single-blinded placebo-controlled hypoglycaemia (nadir plasma glucose 2.4 mmol/L). QTc/QTcF and QT dynamics were registered by Holter monitoring. QTc prolonged during [8 (+/-2.3) ms, P < 0.01] and after [11 (+/-3) ms, P < 0.001] hypoglycaemia. Dynamic QT parameters reacted ambiguously. Low RAS activity was associated with a slightly more pronounced QT prolongation [6 (+/-3) ms, P = 0.04]. Adrenaline tended to increase more in the low-RAS group (P = 0.08) and was correlated to QTc (r = 0.67, P < 0.01) and QTcF (r = 0.58, P < 0.05) during hypoglycaemia. CONCLUSION: Low basal RAS activity may be associated with a slightly more pronounced QT prolongation during hypoglycaemia, when compared with high RAS activity. The impact, however, is modest and the clinical consequence is unclear.
U2 - 10.1093/europace/eun137
DO - 10.1093/europace/eun137
M3 - Journal article
C2 - 18534966
VL - 10
SP - 860
EP - 867
JO - Europace
JF - Europace
SN - 1099-5129
IS - 7
ER -
ID: 8419583