首页> 外文OA文献 >Cardiac Autonomic Regulation and Repolarization During Acute Experimental Hypoglycemia in Type 2 Diabetes
【2h】

Cardiac Autonomic Regulation and Repolarization During Acute Experimental Hypoglycemia in Type 2 Diabetes

机译:2型糖尿病急性实验性低血糖期间的心脏自主调节和再极化

摘要

Hypoglycemia is associated with increased cardiovascular mortality in trials of intensive therapy in type 2 diabetes mellitus (T2DM). We previously observed an increase in arrhythmias during spontaneous prolonged hypoglycemia in patients with T2DM. We examined changes in cardiac autonomic function and repolarization during sustained experimental hypoglycemia. Twelve adults with T2DM and 11 age- and BMI-matched control participants without diabetes underwent paired hyperinsulinemic clamps separated by 4 weeks. Glucose was maintained at euglycemia (6.0 mmol/L) or hypoglycemia (2.5 mmol/L) for 1 h. Heart rate, blood pressure, and heart rate variability were assessed every 30 min and corrected QT intervals and T-wave morphology every 60 min. Heart rate initially increased in participants with T2DM but then fell toward baseline despite maintained hypoglycemia at 1 h accompanied by reactivation of vagal tone. In control participants, vagal tone remained depressed during sustained hypoglycemia. Participants with T2DM exhibited greater heterogeneity of repolarization during hypoglycemia as demonstrated by T-wave symmetry and principal component analysis ratio compared with control participants. Epinephrine levels during hypoglycemia were similar between groups. Cardiac autonomic regulation during hypoglycemia appears to be time dependent. Individuals with T2DM demonstrate greater repolarization abnormalities for a given hypoglycemic stimulus despite comparable sympathoadrenal responses. These mechanisms could contribute to arrhythmias during clinical hypoglycemic episodes.
机译:在2型糖尿病(T2DM)的强化治疗试验中,低血糖与心血管疾病死亡率增加相关。我们先前观察到T2DM患者自发性长期低血糖期间心律不齐的增加。我们检查了持续性实验性低血糖期间心脏自主神经功能和复极化的变化。 12名患有T2DM的成人以及11名年龄和BMI匹配的无糖尿病对照参与者接受了成对的高胰岛素钳夹,间隔4周。血糖维持在正常血糖(6.0 mmol / L)或低血糖(2.5 mmol / L)下1小时。每30分钟评估一次心率,血压和心率变异性,并每60分钟修正一次QT间隔和T波形态。 T2DM参与者的心率最初增加,但尽管在1小时内维持低血糖并伴有迷走神经张力的恢复,但心律降至基线。在对照参与者中,迷走神经张力在持续的低血糖期间仍保持压抑。与对照组相比,T2DM参与者在低血糖期间表现出更大的复极化异质性,如T波对称性和主成分分析比率所证实。两组之间低血糖期间的肾上腺素水平相似。低血糖期间的心脏自主神经调节似乎是时间依赖性的。尽管有相当的交感肾上腺反应,但对于给定的降糖刺激,T2DM患者表现出更大的复极异常。这些机制可能在临床降血糖发作期间导致心律不齐。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号