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Introduction. Le diabète est un facteur de risque cardiovasculaire responsable de complications cardiovasculaires. L’électrocardiogramme est un examen non invasif, permettant de dépister ou diagnostiquer les anomalies cardiovasculaires. Le but de cette étude était de décrire les aspects de l’électrocardiogramme chez les patients diabétiques de type 2 (DT2). Patients et méthodes. Il s’est agi d’une étude descriptive à recrutement prospectif portant sur l’aspect de l’ECG chez les patients DT2 hospitalisés dans le service de médecine et d’endocrinologie de l’hôpital du Mali du 1er Mai 2019 au 27 Février 2020. Résultats. Durant la période de l’étude nous avons colligé 140 patients. L’ECG était anormal chez 55% des patients. Les anomalies retrouvées étaient principalement la tachycardie sinusale (22,9%); l’hypertrophie ventriculaire gauche (9,3%) et une onde q pathologique (7,9%). Les signes électrocardiographiques de cardiopathie ischémique ont été observés chez 15%.. Parmi les patients ayant un ECG anormal, 62,3% avaient une hypertension artérielle associée au DT2 et 63,6% avaient un taux de LDL élevé. L’étude analytique n’a pas retrouvé de liens statistiquement significatifs entre l’hypertension artérielle, la dyslipidémie, le tabagisme, l’obésité, la sédentarité, l’équilibre glycémique, la durée d’évolution du diabète et les modifications d’ECG avec respectivement p= 0,38, p=0,48, p=0,78, p=0,11, p=0,16, p=0,2 et p=0,57. Conclusion. L’ECG au repos chez le diabétique de type 2 objective des anomalies diverses permettant d’identifier des patients avec des stigmates de cardiopathies.
Abstract
Introduction. Diabetes is a cardiovascular risk factor responsible of cardiovascular complications. Electrocardiogram is a non-invasive technique which can detect or diagnose cardiovascular abnormalities. Aim of this study was to describe the aspects of the electrocardiogram in patients with type 2 diabetes (T2DM). Patients and methods. This was a prospectively recruiting descriptive study on the appearance of the ECG in T2DM patients hospitalized in the department of medicine and endocrinology of “hôpital du Mali”from May 1, 2019 to February 27, 2020. Results. During the study period we collected 140 patients. ECG was abnormal in 55% of patients. ECG Abnormalities were mainly sinus tachycardia 22.9%; left ventricular hypertrophy 9.3% and a pathological q wave 7.9%. Electrocardiographic signs of ischemic heart disease were observed in 15% of the patients with abnormal ECG, 62.3% had hypertension associated with T2DM and 63.6% had elevated LDL levels. Analytical study did not found statistically significant associations between hypertension, dyslipidemia, smoking, obesity, sedentary lifestyle, glycemic control, duration of diabetes and ECG changes with p=0.38, p=0.48, p=0.78, p=0.11, p=0.16, p=0.2 and p=0.57 respectively. Conclusion. Resting ECG in type 2 diabetic patients shows some abnormalities allowing the identification of patients with stigmata of heart disease.
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References
- Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. The Lancet. 2010;375(9733):2215‑22.
- Collaboration APCS. The effects of diabetes on the risks of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care. 2003;26(2):360‑6.
- Gregg EW, Cheng YJ, Srinivasan M, Lin J, Geiss LS, Albright AL, et al. Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data. The Lancet. 2018;391(10138):2430‑40.
- Ashley EA, Raxwal VK, Froelicher VF. The prevalence and prognostic significance of electrocardiographic abnormalities. Curr Probl Cardiol. 2000;25(1):1‑72.
- Woolf SH, Battista RN, Anderson GM, Logan AG, Wang E. Assessing the clinical effectiveness of preventive maneuvers: analytic principles and systematic methods in reviewing evidence and developing clinical practice recommendations. A report by the Canadian Task Force on the Periodic Health Examination. J Clin Epidemiol. 1990;43(9).
- Association AD. 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Supplement 1):S125‑50.
- Grant PJ, Cosentino F. The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: new features and the ‘Ten Commandments’ of the 2019 Guidelines are discussed by Professor Peter J. Grant and Professor Francesco Cosentino, the Task Force chairmen. Eur Heart J. 2019;40(39):3215‑7.
- Harms PP, van der Heijden AA, Rutters F, Tan HL, Beulens JWJ, Nijpels G, et al. Prevalence of ECG abnormalities in people with type 2 diabetes: The Hoorn Diabetes Care System cohort. J Diabetes Complications. févr 2021;35(2):107810.
- Dzudie A, Choukem S-P, Kamdem F, Doualla MS, Joko HA, Lobe ME, et al. Prevalence and determinants of electrocardiographic abnormalities in sub-Saharan African individuals with type 2 diabetes: cardiovascular topic. Cardiovasc J Afr. 2012;23(10):533‑7.
- Tougouma SJ-B, Kambiré Y, Bado J, Yaméogo AA, Yaméogo TM, Sidibé S, et al. Electrocardiographie couplé à l’échocardiographie transthoracique de repos dans le diagnostic des atteintes cardiaques chez le diabétique de type 2: les enseignements d’une série transversale au Burkina Faso. Pan Afr Med J [Internet]. 2018 [cité 15 août 2021];31. Disponible sur: http://www.panafrican-med-journal.com/content/article/31/169/full/
- Ndour MA, Abdoulaye L, Codou FB, Mohamed LY, Nafy N, Diaba DN, et al. Electrocardiographic Changes in Patients with Type 2 Diabetes Multicenttic Cross Sectional and Descriptive Study in Dakar. Open J Intern Med. 2017;07(03):64‑73.
- Sow DS, Konaté M, Traoré D, Bah M, Guindo I, Mariko M, et al. Hypertension Artérielle chez les Patients Diabétiques de Type 2 au Centre de Santé de Référence de la Commune I du District de Bamako. Health Sci Dis [Internet]. 28 juill 2020 [cité 30 août 2021];21(8). Disponible sur: https://www.hsd-fmsb.org/index.php/hsd/article/view/2229
- Gupta S. Evaluation of ECG Abnormalities in Patients with Asymptomatic Type 2 Diabetes Mellitus. J Clin Diagn Res [Internet]. 2017 [cité 15 août 2021]; Disponible sur: http://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2017&volume=11&issue=4&page=OC39&issn=0973-709x&id=9740
- Choukem SP, Dzudie A, Adam AK, Kengne AP, Gouking P, Dehayem M, et al. P28 Prévalence et déterminants des anomalies électrocardiographiques dans une population de diabétiques de type 2 Africains sub-Sahariens. Diabetes Metab. 2012;38:A38.
- Pillay S, Hift R, Aldous C. A retrospective analysis of electrocardiographic abnormalities found in black South African patients with diabetes attending a regional hospital in KwaZulu-Natal. J Endocrinol Metab Diabetes South Afr. 2 janv 2018;23(1):9‑16.
- Sellers MB, Divers J, Lu L, Xu J, Smith SC, Bowden DW, et al. Prevalence and determinants of electrocardiographic abnormalities in African Americans with type 2 diabetes. J Epidemiol Glob Health. 2014;4(4):289‑96.
- Dionadji M, Lamlad L, Achbi S, Belhous S, Boudiba A. Facteurs associes a l’ischémie vue a électrocardiogramme de repos chez diabétiques type 2 Associative factors to ischemic in rest electrocardiogram by type 2 diabetic. MALI Med. 2010;25(4).
References
Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. The Lancet. 2010;375(9733):2215‑22.
Collaboration APCS. The effects of diabetes on the risks of major cardiovascular diseases and death in the Asia-Pacific region. Diabetes Care. 2003;26(2):360‑6.
Gregg EW, Cheng YJ, Srinivasan M, Lin J, Geiss LS, Albright AL, et al. Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data. The Lancet. 2018;391(10138):2430‑40.
Ashley EA, Raxwal VK, Froelicher VF. The prevalence and prognostic significance of electrocardiographic abnormalities. Curr Probl Cardiol. 2000;25(1):1‑72.
Woolf SH, Battista RN, Anderson GM, Logan AG, Wang E. Assessing the clinical effectiveness of preventive maneuvers: analytic principles and systematic methods in reviewing evidence and developing clinical practice recommendations. A report by the Canadian Task Force on the Periodic Health Examination. J Clin Epidemiol. 1990;43(9).
Association AD. 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Supplement 1):S125‑50.
Grant PJ, Cosentino F. The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: new features and the ‘Ten Commandments’ of the 2019 Guidelines are discussed by Professor Peter J. Grant and Professor Francesco Cosentino, the Task Force chairmen. Eur Heart J. 2019;40(39):3215‑7.
Harms PP, van der Heijden AA, Rutters F, Tan HL, Beulens JWJ, Nijpels G, et al. Prevalence of ECG abnormalities in people with type 2 diabetes: The Hoorn Diabetes Care System cohort. J Diabetes Complications. févr 2021;35(2):107810.
Dzudie A, Choukem S-P, Kamdem F, Doualla MS, Joko HA, Lobe ME, et al. Prevalence and determinants of electrocardiographic abnormalities in sub-Saharan African individuals with type 2 diabetes: cardiovascular topic. Cardiovasc J Afr. 2012;23(10):533‑7.
Tougouma SJ-B, Kambiré Y, Bado J, Yaméogo AA, Yaméogo TM, Sidibé S, et al. Electrocardiographie couplé à l’échocardiographie transthoracique de repos dans le diagnostic des atteintes cardiaques chez le diabétique de type 2: les enseignements d’une série transversale au Burkina Faso. Pan Afr Med J [Internet]. 2018 [cité 15 août 2021];31. Disponible sur: http://www.panafrican-med-journal.com/content/article/31/169/full/
Ndour MA, Abdoulaye L, Codou FB, Mohamed LY, Nafy N, Diaba DN, et al. Electrocardiographic Changes in Patients with Type 2 Diabetes Multicenttic Cross Sectional and Descriptive Study in Dakar. Open J Intern Med. 2017;07(03):64‑73.
Sow DS, Konaté M, Traoré D, Bah M, Guindo I, Mariko M, et al. Hypertension Artérielle chez les Patients Diabétiques de Type 2 au Centre de Santé de Référence de la Commune I du District de Bamako. Health Sci Dis [Internet]. 28 juill 2020 [cité 30 août 2021];21(8). Disponible sur: https://www.hsd-fmsb.org/index.php/hsd/article/view/2229
Gupta S. Evaluation of ECG Abnormalities in Patients with Asymptomatic Type 2 Diabetes Mellitus. J Clin Diagn Res [Internet]. 2017 [cité 15 août 2021]; Disponible sur: http://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2017&volume=11&issue=4&page=OC39&issn=0973-709x&id=9740
Choukem SP, Dzudie A, Adam AK, Kengne AP, Gouking P, Dehayem M, et al. P28 Prévalence et déterminants des anomalies électrocardiographiques dans une population de diabétiques de type 2 Africains sub-Sahariens. Diabetes Metab. 2012;38:A38.
Pillay S, Hift R, Aldous C. A retrospective analysis of electrocardiographic abnormalities found in black South African patients with diabetes attending a regional hospital in KwaZulu-Natal. J Endocrinol Metab Diabetes South Afr. 2 janv 2018;23(1):9‑16.
Sellers MB, Divers J, Lu L, Xu J, Smith SC, Bowden DW, et al. Prevalence and determinants of electrocardiographic abnormalities in African Americans with type 2 diabetes. J Epidemiol Glob Health. 2014;4(4):289‑96.
Dionadji M, Lamlad L, Achbi S, Belhous S, Boudiba A. Facteurs associes a l’ischémie vue a électrocardiogramme de repos chez diabétiques type 2 Associative factors to ischemic in rest electrocardiogram by type 2 diabetic. MALI Med. 2010;25(4).