Changes of Virtual Planar QRS and T Vectors Derived from Holter in the Populations with and without Diabetes Mellitus.
OBJECTIVE
Research related to type 2 diabetes mellitus (DM) and parameters of electrocardiography (ECG) was limited. Patients with and without DM (NDM) were randomly enrolled in a study to exploit the influence of DM on planar QRS and T vectors derived from the Virtual Holter process.


METHODS
A total of 216 (NDM) and 127 DM patients were consecutively and randomly recruited. We selected a 1-minute length of ECG, which was scheduled for analysis at 4 AM. After a series of calculating algorisms, we received the virtual planar vector parameters.


RESULTS
Patients with DM were elderly (65.61 ± 12.08 vs 59.41 ± 16.86 years, P < 0.001); higher morbidity of hypertension (76.38% vs 58.14%, P < 0.001) and coronary artery disease (44.09% vs 32.41%, P = 0.03); thicker interventricular septum (10.92 ± 1.77 vs 10.08 ± 1.96 mm, P < 0.001) and left ventricular posterior wall (9.84 ± 1.38 vs 9.39 ± 1.66 mm, P = 0.03); higher lipid levels and average heart rate (66.67 ± 12.04 vs 61.87 ± 13.36 bpm, P < 0.01); higher angle of horizontal QRS vector (HQRSA, -2.87 ± 48.48 vs -19.00 ± 40.18 degrees, P < 0.01); lower maximal magnitude of horizontal T vector (HTV, 2.33 ± 1.47 vs 2.88 ± 1.89 mm, P = 0.01) and maximal magnitude of right side T vector (2.77 ± 1.55 vs 3.27 ± 1.92 mm, P = 0.03), and no difference in angle of frontal QRS-T vector (FQRSTA, 32.77 ± 54.20 vs 28.39 ± 52.87 degrees, P = 0.74) compared with patients having NDM. After adjusting for confounding factors, DM was significantly effective on FQRSTA (regression coefficient -40.0, 95%CI -66.4 to -13.6, P < 0.01), HQRSA (regression coefficient 22.6, 95%CI 2.5 to 42.8, P = 0.03), and HTV (regression coefficient 0.9, 95%CI 0.2 to 1.7, P = 0.01). Confounding factors included: sex, 2-hour postprandial blood glucose, smoking, triglyceride, apolipoprotein A, creatinine, left ventricular ejection fraction, and average heart rate.


CONCLUSIONS
The risk factors of DM and lipid metabolism abnormality particularly apolipoprotein A significantly modified parameters of virtual planar QRS and T vector, including frontal QRS-T angle.
First Affiliated Hospital of Jinan University, Second Department of Cardiology, Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
Jia
J
Chen
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.|Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangdong General hospital, Guangzhou, 510080, P.R., China.
Yubi
Y
Lin
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Jian
J
Yu
Medical College of Jinan University, Guangzhou, China.
Wanqun
W
Chen
Division of Cardiac Surgery, First Affiliated Hospital of Sun-Yat-sen University, Guangzhou, China.
Zhe
Z
Xu
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Zhenzhen
Z
Yang
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Chuqian
C
Zeng
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Wenfeng
W
Li
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Xiaoshu
X
Lai
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Qiji
Q
Lu
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Jingwen
J
Zhou
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Bixia
B
Tian
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Jing
J
Xu
Medical College of Guangdong Province, Zhanjiang, China.
Yanping
Y
Lin
Second Department of Cardiology, Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
Zuoyi
Z
Du
Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Aidong
A
Zhang
D000368:Aged; D053241:Apoprotein(a) / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D058065:Diabetic Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012307:Risk Factors
D053241:Apoprotein(a)
diabetes mellitus; electrocardiography monitoring; planar vector