Related Experiment Video
Updated: Jun 25, 2026
Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes
Published on: September 18, 2017
Diabetes does not affect ventricular repolarization and sudden cardiac death risk in patients with dilated
Bojan Vrtovec1, Misa Fister, Gregor Poglajen
1Advanced Heart Failure Center, Department of Cardiology, Ljubljana University Medical Center, Ljubljana, Slovenia. gmrstabile@tin.it
Insights
Diabetes increases heart failure risk in dilated cardiomyopathy patients, but does not impact ventricular repolarization or sudden cardiac death. This study highlights diabetes as a predictor of mortality in DCM.
Area of Science:
- Cardiology
- Diabetology
- Clinical Research
Background:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- The impact of diabetes on cardiac outcomes in DCM patients requires further investigation.
- Ventricular repolarization and sudden cardiac death are critical concerns in heart failure management.
Purpose of the Study:
- To investigate the effects of diabetes on ventricular repolarization parameters.
- To assess the association between diabetes and sudden cardiac death in patients with DCM.
- To determine if diabetes influences overall mortality and heart failure-specific mortality in DCM.
Main Methods:
- 132 patients with DCM (NYHA class II-III, LVEF <40%) were enrolled.
- Patients were categorized into diabetic (n=45) and non-diabetic (n=87) groups.
- High-resolution ECGs were used to determine QT variability (QTV) index, with 1-year follow-up for mortality.
Main Results:
- Diabetes did not significantly alter QTV index compared to controls.
- Overall mortality (20% vs 10%) and heart failure mortality (13% vs 2%) were higher in diabetic patients.
- Diabetes predicted total and heart failure mortality, while high QTV predicted sudden cardiac death.
Conclusions:
- Diabetes is associated with increased risk of heart failure mortality in DCM patients.
- Ventricular repolarization parameters and sudden cardiac death risk are not significantly affected by diabetes in this cohort.
- Diabetes is an independent predictor of adverse outcomes in DCM.
Background:
We studied the effects of diabetes on ventricular repolarization parameters and sudden cardiac death in patients with dilated cardiomyopathy (DCM).
Methods:
We enrolled 132 consecutive patients in New York Heart Association (NYHA) heart failure functional classes II or III and left ventricular ejection fraction <40% without evidence of coronary artery disease. In 45 patients (34%), diabetes was diagnosed according to standard criteria (study group), and the remaining 87 (66%) had no diabetes (controls). All patients underwent a 5-minute high-resolution electrocardiogram recording for determination of QT variability (QTV) index and were followed for 1 year thereafter.
Results:
At baseline, the two groups did not differ in age, gender, left ventricular ejection fraction, NYHA functional class, or plasma brain natriuretic peptide levels. Similarly, QTV index did not differ between the study group (-0.51 +/- 0.55) and controls (-0.48 +/- 0.51; P = 0.48). During follow-up, 18 patients (14%) died of cardiac causes. Of the 18 deaths, eight were attributed to heart failure, and 10 to sudden cardiac death. Mortality was higher in the study group (10/45, 20%) than in controls (8/87, 10%) (P = 0.03). The same was true of the heart failure mortality (6/45 [13%] vs 2/87 [2%], P = 0.01), but not of the sudden cardiac death rate (3/45 [7%] vs 7/87 [8%], P = 0.78). By multiple variable analyses, diabetes predicted total and heart failure mortality, and a high QTV predicted sudden cardiac death.
Conclusions:
Diabetes appears to increase the risk of heart failure in patients with DCM without affecting ventricular repolarization parameters and sudden cardiac death risk.
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:25Cardiomyopathy I: Introduction and Classification
01:29Cardiomyopathy V: Interprofessional Care
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...