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Relationship Between Index of Cardiac Electrophysiological Balance, Frontal QRS-T Angle and Retinopathy in People
Yi-Tong Zhang1, Hui-Yao Li1, Xiao-Tong Sun1
1Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People's Republic of China.
Insights
Increased cardiac electrophysiological balance (iCEB) and frontal QRS-T angle are linked to diabetic retinopathy (DR) progression. These ECG markers may help predict DR risk in patients with type 2 diabetes mellitus.
Area of Science:
- Cardiology
- Ophthalmology
- Diabetology
Background:
- Diabetic retinopathy (DR) is linked to cardiovascular disease and sudden cardiac death.
- Index of cardiac electrophysiological balance (iCEB) and frontal QRS-T angle predict ventricular arrhythmias.
- The relationship between these ECG markers and DR is not well understood.
Purpose of the Study:
- To investigate variations in iCEB, corrected iCEB (iCEBc), and frontal QRS-T angle across DR stages.
- To determine associations between these ECG markers and DR risk.
Main Methods:
- 665 patients with Type 2 Diabetes Mellitus (T2DM) were categorized into no DR, mild-to-moderate non-proliferative DR (NPDR), and vision-threatening DR (VTDR) groups.
- Twelve-lead ECGs were recorded to measure QT, QTc, QRS duration, iCEB, iCEBc, and frontal QRS-T angle.
- Statistical analyses compared ECG parameters across DR groups and assessed correlations with DR risk.
Main Results:
- The VTDR group exhibited significantly higher iCEBc and frontal QRS-T angle compared to NDR and NPDR groups.
- Increased iCEBc and frontal QRS-T angle remained significantly associated with DR risk after controlling for confounders.
- Higher quartiles of iCEBc and frontal QRS-T angle correlated with substantially increased odds of developing DR.
Conclusions:
- Both iCEBc and frontal QRS-T angle increase with DR progression.
- Elevated iCEBc and frontal QRS-T angle are associated with a higher risk of diabetic retinopathy.
Background:
Diabetic retinopathy (DR) is strongly associated with cardiovascular disease, which is a risk factor for sudden cardiac death (SCD). The index of cardiac electrophysiological balance (iCEB) and the frontal QRS-T angle are recommended to predict the risk of ventricular arrhythmias more than other ECG parameters. However, the relationships between these two markers and DR have not yet been explored. The aim of this study was to investigate the variation in the iCEB, corrected iCEB (iCEBc) and frontal QRS-T angle in different stages of DR and determine whether there are associations between these markers and DR.
Methods:
The sample comprised 665 patients with Type 2 diabetes mellitus (T2DM) who were classified into three groups: no DR (NDR), mild to moderate non-proliferative DR (NPDR), and vision-threatening DR (VTDR). Twelve-lead ECG was performed and the QT, QTc, QRS duration, iCEB, iCEBc and frontal QRS-T angle were recorded and compared across the groups.
Results:
The VTDR group had a significantly higher iCEBc and frontal QRS-T angle than the NDR and NPDR groups. After controlling for confounding variables, the correlations between the iCEBc (OR=2.217, 95% CI=1.464-3.358, P<0.001), frontal QRS-T angle (OR=1.017, 95% CI=1.008-1.025, P<0.001) and DR risk remained (P<0.05). Subjects in the fourth iCEBc quartile (adjusted OR=2.612, 95% CI=1.411-4.834, p=0.002) had a much higher chance of developing DR compared to those in the first quartile. In comparison to the first frontal QRS-T angle quartile, subjects in the third (adjusted OR=1.998, 95% CI=1.167-3.422, P=0.012) and fourth (adjusted OR=2.430, 95% CI=1.420-4.160, P=0.001) frontal QRS-T angle quartiles had significantly greater risks of DR.
Conclusion:
With the progression of DR, the iCEBc and frontal QRS-T angle increase. An increased iCEBc and frontal QRS-T angle are associated with an increased risk of DR.
