CİHAN FİDAN, Bünyamin YAVUZ, Ömer ŞEN, Derun Taner ERTUĞRUL, Yaşar NAZLIGÜL

Increased P Wave Dispersion In Patients With Diabetic Ketoacidosis

Diyabetik ketoasidoz (DKA) diyabetes mellitus (DM) olan hastalarda en sık hiperglisemik acil durumdur. Ayrıca atriyal fibrilasyon (AF) insidansı diyabetik hastalarda yüksektir. P dalga dispersiyonu (PDD) bir noninvaziv EKG parametresidir ve AF gibi artiyal aritmili hastalarda artmaktadır. Bu çalışmanın amacı, DKA'nın PDD üzerine etkisini incelemektir. Yöntem: Çalışmaya acil servise DKA ile başvuran 53 tip 2 DM hastası alındı. Tüm hastalar sinüs ritmindeydi ve kan glukozu, idrar ketonu, elektrolitler, üre, kreatinin, arteriyal kan gazı gibi laboratuvar değerleri ölçüldü. Tüm hastalara standart 12 derivasyonlu EKG çekildi ve PDD en uzun ve en kısa P dalga süresi arasındaki fark olarak hesaplandı (PDD=Pmaks-Pmin). Pmaks, Pmin ve PDD ketoasidoz sırasında ölçüldü ve idrar ketonunun negatifleşmesinden en az 6 saat sonra tekrar değerlendirildi. Bulgular: Hastaların çoğunluğu kadındı (K/E:37/16) ve ortalama yaş 53.1±15.0 idi. Hastaların ortalama plazma glukoz seviyesi 400.6±119 mg/dL idi. PDD ve Pmaks'ın ketoasidoz sırasında, idrar ketonu negatifleştikten 6 saat sonrasına göre daha yüksek olduğunu belirledik [60 ms; 40 ms, (p

Diyabetik Ketoasidozun P Dalga Dispersiyonu Üzerine Etkisi

Diabetic ketoacidosis (DKA) is the most common hyperglycemic emergency in patients with diabetes mellitus (DM). Further, atrial fibrillation (AF) incidence is higher in diabetic patients. P wave dispersion (PWD) is a non-invasive electrocardiographic parameter and increases in patients with atrial arrhythmias such as AF. The aim of this study was to examine the effect of DKA on PWD. Methods: Fifty-three type 2 DM patients with DKA were included in the study. All patients had sinus rhythm and laboratory parameters such as blood glucose, urinary ketones, electrolytes, urea, creatinine, arterial blood gas were measured. We performed the standard 12-lead electrocardiogram to all patients and PWD was calculated as the difference between the longest and shortest P wave duration (PWD=Pmax-Pmin). Pmax, Pmin and PWD were measured during ketoacidosis and reevaluated at least six hours later from urinary ketone being negative. Results: The majority of the patients were female (F/M: 37/16) and the mean age was 53.1±15.0 years. The mean plasma glucose level was 400.6±119.1 mg/dL. We detected that PWD and Pmax during ketoacidosis was higher than six hours later from urinary ketone being negative [60 ms; 40 ms, (p<0.001) and 110 ms; 80 ms, (p<0.001) respectively]. There was no significant relationship between PWD and Pmax with regard to any biochemical and demographic data. Conclusion: The results showed that PWD, which is a predictor factor for atrial artyhythmias, is increased during ketoacidosis and decreased after treatment of ketoacidosis. Therefore, we suggest that these patients should be monitored during ketoacidosis treatment for following up arrhythmias

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