Prolonged QTc interval in adults with diabetic ketoacidosis: is it only electrolyte disturbance?

Khalil, Osama A.; Samir, Ghada M.; Sadek, Ayman Magd Eldin Mohammad

doi:10.4103/ejim.ejim_112_18

Cited by 4 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In accordance with our results Khalil et al (5) , revealed that Patients with prolonged QTmaxc in our study had a significantly lower pH at presentation compared with those with nonprolonged QTmaxc values, with a significant positive correlation between QTmaxc and Anion gap, and a significant negative correlation between QTmaxc and pH. The QTmaxc interval prolongation was significantly decreased (P<0.001) with the recovery from DKA in 35 patients; meanwhile, 11 patients had persistent prolonged QTmaxc even after recovery from DKA, which had returned to normal after one week of hospital discharge.…”

Section: Discussionsupporting

confidence: 94%

“…After treatment the prevalence of QTmaxc interval prolongation was significantly diminished (P<0.001) as only 20 patients still had prolonged QTmaxc. This was supported by Khalil et al (5) , study who reported the frequency of QTmaxc interval prolongation without electrolyte imbalance was seen in 46 (63.9%) patients. The QTmaxc prolongation was significantly decreased (P<0.001) with the recovery from DKA in 35 patients; meanwhile, 11 patients had persistent prolonged QTmaxc even after recovery from DKA, which had returned to normal after one week of hospital discharge.…”

Section: Discussionsupporting

confidence: 61%

“…The QTmaxc interval prolongation was significantly decreased (P<0.001) with the recovery from DKA in 35 patients; meanwhile, 11 patients had persistent prolonged QTmaxc even after recovery from DKA, which had returned to normal after one week of hospital discharge. This illustrated the effect of acidosis that may precipitate arrhythmias such as reentry, pulsus alternans, and early/delayed afterdepolarization, embracing the findings of other studies (5,9,11) . Also, our findings were supported by Youssef and Farid (11) , who revealed that During DKA, patients with prolonged QTc and those with prolonged QTd had a significant higher anion gap and lower PH at presentation compared to those with normal QTc and QTd values, while no significant difference was found between both groups of patients in other biochemical or clinical data.…”

Section: Discussionmentioning

confidence: 65%

“…Logistic regression for independent predictors of prolonged QTmaxc of our patients showed that anion gap was significant independent risk factor for QTmaxc prolongation, while PH and HCo3 were excluded from model because they had zero value. In contrast Khalil et al (5) performed a multivariate logistic regression analysis to confirm that pH was a significant independent predictor for QTmaxc prolongation, with a cutoff value of 7.03, enforcing the results of Adeva-Andany et al (18) .…”

Section: Discussionmentioning

confidence: 73%

“…During DKA, ketosis or acidosis may directly affect cardiac repolarization with prolongation of QTc interval, leading to arrhythmia and cardiac arrest (5) . Most of the previous studies had reported prolongation of QTc interval in children during DKA with a suggestion of whether ketosis or acidosis may directly affect cardiac repolarization and cause arrhythmia and cardiac arrest during DKA, but few data were reported in adult (5,6) .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prolongation of Corrected QT Interval in Diabetic Patients with Ketoacidosis

Hussein¹,

Abdelmonem²,

Bendary³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prolongation of Corrected QT Interval in Diabetic Patients with Ketoacidosis

Hussein¹,

Abdelmonem²,

Bendary³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Evaluation of Cardiac Arrhythmias in Diabetic Patients Admitted to Intensive Care Unit with Acute Hyperglycemic Syndromes: Prospective One Year Study

2023

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: The association among ketotic or hyperglycemic conditions and cardiac arrhythmias and sudden death increases possibility that ketosis or hyperglycemia may directly disrupt cardiac repolarization and hence be reason for arrhythmia and sudden cardiac death in these cases. Objective: The goal of the research was to assess ECG variations among diabetic studied cases admitted in Intensive Care Unit (ICU) with acute hyperglycemic syndromes. Patients and Methods: This study was prospective follow-up study and was conducted on patients admitted to medical critical care unit, Specialized Medical Hospital, Mansoura University during the period from January 2021 to January 2022. Results: There was significant (P<0.001) decrease in average heart rate, p wave maximum, p wave dispersion, QT maximum, QT dispersion and QTc. The depressed ST segment decreased from 4.8% to 3.8% with no significant difference, while the percentages of all types of arrhythmias are decreased on recovery in comparison to their values on admission. Conclusion: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) could be associated with several types of cardiac arrhythmias, which attributed to hyperglycemia and ketoacidosis rather than electrolyte disturbances.

show abstract

Cardiac Arrest Related to Torsades de Pointes in a Patient Recovering from Diabetic Ketoacidosis

Kim¹,

Lee²,

Yoo³

et al. 2021

Korean J Med

View full text Add to dashboard Cite

Diabetic ketoacidosis (DKA) is an acute complication related to severe hyperglycemia. While the mortality rate for DKA is low with appropriate therapy, several complications may lead to deterioration of the clinical course. Here, we report a case of a 23-year-old patient with DKA who suffered from a rare but hemodynamically unstable cardiac arrhythmia, polymorphic ventricular tachycardia with prolonged QT interval, or Torsades de Pointes. During the recovery phase of DKA, three episodes of Torsades de Pointes suddenly occurred, and were recovered by immediate defibrillation. The patient did not have structural heart disease or a genetic predisposition. To the best of our knowledge, this is the first report of an adult with DKA complicated with QT prolongation related to Torsades de Points after correction of ketosis. To manage DKA, more attention may be needed on changes in the QT interval as well as risk factors for Torsades de Points.

show abstract

Prolonged QTc interval in adults with diabetic ketoacidosis: is it only electrolyte disturbance?

Cited by 4 publications

References 16 publications

Prolongation of Corrected QT Interval in Diabetic Patients with Ketoacidosis

Prolongation of Corrected QT Interval in Diabetic Patients with Ketoacidosis

Evaluation of Cardiac Arrhythmias in Diabetic Patients Admitted to Intensive Care Unit with Acute Hyperglycemic Syndromes: Prospective One Year Study

Cardiac Arrest Related to Torsades de Pointes in a Patient Recovering from Diabetic Ketoacidosis

Contact Info

Product

Resources

About