Exercise does not increase QTcmax and QTcd in diabetic patients with autonomic neuropathy

The purpose of this study was to examine the effects of exercise on maximum QTc interval (QTcmax) and QTc dispersion (QTcd) in diabetic patients without clinically evident heart disease.

Seventy-six diabetic patients who had no coronary artery disease or hypertension (group I; mean age 48 +/- 9 years old) and 40 healthy volunteers (group II; mean age 46 +/- 13 years old) were enrolled in the study. Cases with clinically evident heart disease were excluded from the study. Resting 12-lead electrocardiogram (ECG) and maximal treadmill exercise test (according to Bruce protocol) were performed in all cases. The QTcmax interval was determined at rest (RQTcmax) and during peak exercise (PQTcmax). Also, the QTcd was measured at rest (RQTcd) and during peak exercise (PQTcd). Autonomic neuropathy was assessed by measuring the heart rate variability (HRV).

There was no significant difference between clinical characteristics of two groups. In group I, HRV parameters were significantly lower than group II. RQTcd, PQTcd, RQTcmax, and PQTcmax were significantly longer in group I (56 +/- 16 vs 34 +/- 11; P< 0.001, 62 +/- 22 vs 40 +/- 15; P < 0.001, respectively). In diabetic patients, there was no significant difference between RQTcmax and PQTcmax (428 +/- 19 vs 420 +/- 31; P > 0.05), and no significant difference was present between RQTcd and PQTcd (56 +/- 16 vs 62 +/- 22; P > 0.05, respectively).

Exercise does not affect QTcd in patients with diabetes mellitus and without clinically evident heart disease.