Left ventricular hypertrophy and QTc dispersion are predictors of long-term mortality in subjects with type 2 diabetes

Bianco, Henrique Tria; Izar, Maria Cristina de Oliveira; Póvoa, Rms; Bombig, Maria Teresa Nogueira; Fonseca, Henrique Andrade Rodrigues da; Helfenstein, Tatiana; Ferreira, Carlos Eduardo; Nicolau, José Carlos; Neto, Abrahão Afiune; Feio, Claudine Maria Alves; Cerci, Mario; Fonseca, Francisco A.

doi:10.1016/j.ijcard.2014.07.251

Cited by 4 publications

(1 citation statement)

References 11 publications

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“…Multivariate analysis of these studies showed a 34% increased cardiovascular risk for each increment of 17ms in QTbD or QTcD > 60 ms in patients with diabetes mellitus without previous AMI. 20 - 22…”

Section: Discussionmentioning

confidence: 99%

Regional QT Interval Dispersion as an Early Predictor of Reperfusion in Patients with Acute Myocardial Infarction after Fibrinolytic Therapy

Dotta¹,

Fonseca²,

Izar³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundPatients with ST-elevation acute myocardial infarction attending primary care centers, treated with pharmaco-invasive strategy, are submitted to coronary angiography within 2-24 hours of fibrinolytic treatment. In this context, the knowledge about biomarkers of reperfusion, such as 50% ST-segment resolution is crucial.ObjectiveTo evaluate the performance of QT interval dispersion in addition to other classical criteria, as an early marker of reperfusion after thrombolytic therapy.MethodsObservational study including 104 patients treated with tenecteplase (TNK), referred for a tertiary hospital. Electrocardiographic analysis consisted of measurements of the QT interval and QT dispersion in the 12 leads or in the ST-segment elevation area prior to and 60 minutes after TNK administration. All patients underwent angiography, with determination of TIMI flow and Blush grade in the culprit artery. P-values < 0.05 were considered statistically significant.ResultsWe found an increase in regional dispersion of the QT interval, corrected for heart rate (regional QTcD) 60 minutes after thrombolysis (p = 0.06) in anterior wall infarction in patients with TIMI flow 3 and Blush grade 3 [T3B3(+)]. When regional QTcD was added to the electrocardiographic criteria for reperfusion (i.e., > 50% ST-segment resolution), the area under the curve increased to 0.87 [(0.78-0.96). 95% IC. p < 0.001] in patients with coronary flow of T3B3(+). In patients with ST-segment resolution >50% and regional QTcD > 13 ms, we found a 93% sensitivity and 71% specificity for reperfusion in T3B3(+), and 6% of patients with successful reperfusion were reclassified.ConclusionOur data suggest that regional QTcD is a promising non-invasive instrument for detection of reperfusion in the culprit artery 60 minutes after thrombolysis.

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Section: Discussionmentioning

confidence: 99%

Regional QT Interval Dispersion as an Early Predictor of Reperfusion in Patients with Acute Myocardial Infarction after Fibrinolytic Therapy

Dotta¹,

Fonseca²,

Izar³

et al. 2018

Arquivos Brasileiros De Cardiologia

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Prevalence of ECG abnormalities in people with type 2 diabetes: The Hoorn Diabetes Care System cohort

Harms

Heijden

Rutters

et al. 2021

Journal of Diabetes and its Complications

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Octanoate is differentially metabolized in liver and muscle and fails to rescue cardiomyopathy in CPT2 deficiency

Pereyra

Harris

Soepriatna

et al. 2021

Journal of Lipid Research

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Long-chain fatty acid oxidation is frequently impaired in primary and systemic metabolic diseases affecting the heart; thus, therapeutically increasing reliance on normally minor energetic substrates, such as ketones and medium-chain fatty acids, could benefit cardiac health. However, the molecular fundamentals of this therapy are not fully known. Here, we explored the ability of octanoate, an eight-carbon medium-chain fatty acid known as an unregulated mitochondrial energetic substrate, to ameliorate cardiac hypertrophy in long-chain fatty acid oxidation-deficient hearts because of carnitine palmitoyltransferase 2 deletion ( Cpt2 M−/− ). CPT2 converts acylcarnitines to acyl-CoAs in the mitochondrial matrix for oxidative bioenergetic metabolism. In Cpt2 M − / − mice, high octanoate-ketogenic diet failed to alleviate myocardial hypertrophy, dysfunction, and acylcarnitine accumulation suggesting that this alternative substrate is not sufficiently compensatory for energy provision. Aligning this outcome, we identified a major metabolic distinction between muscles and liver, wherein heart and skeletal muscle mitochondria were unable to oxidize free octanoate, but liver was able to oxidize free octanoate. Liver mitochondria, but not heart or muscle, highly expressed medium-chain acyl-CoA synthetases, potentially enabling octanoate activation for oxidation and circumventing acylcarnitine shuttling. Conversely, octanoylcarnitine was oxidized by liver, skeletal muscle, and heart, with rates in heart 4-fold greater than liver and, in muscles, was not dependent upon CPT2. Together, these data suggest that dietary octanoate cannot rescue CPT2-deficient cardiac disease. These data also suggest the existence of tissue-specific mechanisms for octanoate oxidative metabolism, with liver being independent of free carnitine availability, whereas cardiac and skeletal muscles depend on carnitine but not on CPT2.

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Left ventricular hypertrophy and QTc dispersion are predictors of long-term mortality in subjects with type 2 diabetes

Cited by 4 publications

References 11 publications

Regional QT Interval Dispersion as an Early Predictor of Reperfusion in Patients with Acute Myocardial Infarction after Fibrinolytic Therapy

Regional QT Interval Dispersion as an Early Predictor of Reperfusion in Patients with Acute Myocardial Infarction after Fibrinolytic Therapy

Prevalence of ECG abnormalities in people with type 2 diabetes: The Hoorn Diabetes Care System cohort

Octanoate is differentially metabolized in liver and muscle and fails to rescue cardiomyopathy in CPT2 deficiency

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