Type 1 diabetes is associated with T-wave morphology changes. The Thousand & 1 Study.

ABSTRACT

BACKGROUND: Repolarization is impaired in patients with type 1 diabetes mellitus (T1DM), and repolarization disturbances are associated with an increased mortality. To study cardiac repolarization, we assessed T-wave morphology in patients with T1DM without known heart disease. METHODS: 855 T1DM patients without known heart disease were matched 12 with 1710 people from a background population. Rate-corrected T-wave morphology markers were obtained. Patients were stratified by albuminuria. Results are mean ±â€¯standard deviation. RESULTS: T-waves were flatter (0.398 ±â€¯0.059 vs. 0.382 ±â€¯0.062, p < 0.001) and more asymmetric (0.082 ±â€¯0.068 vs. 0.071 ±â€¯0.084, p = 0.001) in T1DM. Patients with albuminuria had an increased heart rate (normoalbuminuria 71 ±â€¯13 bpm, microalbuminuria 75 ±â€¯12 bpm, p < 0.001, macroalbuminuria 78 ±â€¯12 bpm, p < 0.001) and more asymmetric T-waves (normoalbuminuria 0.079 ±â€¯0.060, microalbuminuria 0.094 ±â€¯0.085, p < 0.01, macroalbuminuria 0.101 ±â€¯0.080, p < 0.01), but the QTc interval remained unchanged. CONCLUSIONS: T1DM is associated with changes in T-wave morphology. T-wave asymmetry but not QTc interval is associated with albuminuria in T1DM and may be used for stratification.